International Conference on Partitioning in Aqueous Two-Phase Systems in Biochemistry Cell Biology and Biotechnology (7th) Held in New Orleans, Louisiana on June 2-7, 1991.

DTIC Science & Technology

1991-11-30

and Virus Like Particles (VLPs, cloned in yeast presently being used for the development of an AIDS vaccine). This paper will describe partition...PARTITIONING OF CEREBROCORTICAL SYNAPTOSOMES M. J. L6pez.P6rez Departamento de Bioquimica y Biologia Molecular y Celular . Facultad de Veterinaria...Pascual, T. Muifio-Blanco, J. A. Cebriin-Pdrez and M. J. L6pez-Pdrez. Departamento de Bioqufmica y Biologia Molecular y Celular . Facultad de

Evaluating the Training Needs of Active Duty and Reserve Military General Surgeons

DTIC Science & Technology

1998-06-01

Speaker - Legal Advocates Seminar: "Motor Vehicle Crash Analysis."Sheraton Bal Harbor. Miami Beach, FL. January 30t. 1997 SICU Infections Course...Surgical Intensive Care Data Managem3nt System." London, England. June 2nd. 1981 VII Reuni6n Nacional de Medicina CrItica y Terapia Intensiva...Asociaci6n Mexicana de Medicine Critica y Terapia Intensive. Curso de Actualizaci6n Profesional en Medicina CrItica: "Development of Intensive Care Systems

Comparison between qualitative and real-time polymerase chain reaction to evaluate minimal residual disease in children with acute lymphoblastic leukemia.

PubMed

Paula, Francisco Danilo Ferreira; Elói-Santos, Silvana Maria; Xavier, Sandra Guerra; Ganazza, Mônica Aparecida; Jotta, Patricia Yoshioka; Yunes, José Andrés; Viana, Marcos Borato; Assumpção, Juliana Godoy

2015-01-01

Minimal residual disease is an important independent prognostic factor that can identify poor responders among patients with acute lymphoblastic leukemia. The aim of this study was to analyze minimal residual disease using immunoglobulin (Ig) and T-cell receptor (TCR) gene rearrangements by conventional polymerase chain reaction followed by homo-heteroduplex analysis and to compare this with real-time polymerase chain reaction at the end of the induction period in children with acute lymphoblastic leukemia. Seventy-four patients diagnosed with acute lymphoblastic leukemia were enrolled. Minimal residual disease was evaluated by qualitative polymerase chain reaction in 57 and by both tests in 44. The Kaplan-Meier and multivariate Cox methods and the log-rank test were used for statistical analysis. Nine patients (15.8%) were positive for minimal residual disease by qualitative polymerase chain reaction and 11 (25%) by real-time polymerase chain reaction considering a cut-off point of 1×10(-3) for precursor B-cell acute lymphoblastic leukemia and 1×10(-2) for T-cell acute lymphoblastic leukemia. Using the qualitative method, the 3.5-year leukemia-free survival was significantly higher in children negative for minimal residual disease compared to those with positive results (84.1%±5.6% versus 41.7%±17.3%, respectively; p-value=0.004). There was no significant association between leukemia-free survival and minimal residual disease by real-time polymerase chain reaction. Minimal residual disease by qualitative polymerase chain reaction was the only variable significantly correlated to leukemia-free survival. Given the difficulties in the implementation of minimal residual disease monitoring by real-time polymerase chain reaction in most treatment centers in Brazil, the qualitative polymerase chain reaction strategy may be a cost-effective alternative. Copyright © 2015 Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular. Published by Elsevier Editora Ltda. All rights reserved.

Seroprevalence, cost per donation and reduction in blood supply due to positive and indeterminate results for infectious markers in a blood bank in Lima, Peru.

PubMed

Moya-Salazar, Jeel; Ubidia-Incio, Roberto; Incio-Grande, Maritza; Blejer, Jorgelina L; Gonzalez, Carlos A

Safety in Transfusion Medicine is subject to regulations and government legislation within a total quality framework. The aim of this study was to evaluate the impact of seroprevalence and indeterminate results on lost units and cost per donation. A prospective cross-sectional study was performed in the Blood Bank and Transfusion Therapy Department of the Hospital Central de la Policia Nacional del Perú in Lima, Peru. All completed donations (replacement/voluntary) without complications were included in this study. Every donation met the institutional requirements and quality criteria of Programa Nacional de Hemoterapia y Bancos de Sangre (PRONAHEBAS). Data analysis was achieved using the Statistical Package for the Social Sciences. A total of 7723 donations were evaluated during 2014 and 2015 with 493 being seropositive (overall prevalence 5.25%) and 502 having indeterminate results (overall prevalence 5.35%). Thus total loss was 995units, 437.8L of blood and 49,750 US dollars. The most common seropositive infectious markers were the core antibody of hepatitis B virus (2.82%) and syphilis (1.02%), and the most common indeterminate results were Chagas disease (1.27%) and the core antibody of hepatitis B virus (1.26%). There was no significant change in the prevalence of seropositivity (p-value=0.243) or indeterminate results (p-value=0.227) over the two-year period of the study. A statistical correlation was found between the cost per lost donation and the most prevalent markers (rho=0.848; p-value=<0.001). Seroprevalence was lower than the regional mean, but the prevalence of indeterminate results was elevated causing a great impact on blood supply and economic losses to this institution. Copyright © 2017 Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular. Published by Elsevier Editora Ltda. All rights reserved.

Absence of accelerated atherosclerotic disease progression after intracoronary infusion of bone marrow derived mononuclear cells in patients with acute myocardial infarction--angiographic and intravascular ultrasound--results from the TErapia Celular Aplicada al Miocardio Pilot study.

PubMed

Arnold, Roman; Villa, Adolfo; Gutiérrez, Hipólito; Sánchez, Pedro L; Gimeno, Federico; Fernández, Maria E; Gutiérrez, Oliver; Mota, Pedro; Sánchez, Ana; García-Frade, Javier; Fernández-Avilés, Francisco; San Román, Jose A

2010-06-01

We tried to evaluate a putative negative effect on coronary atherosclerosis in patients receiving intracoronary infusion of unfractionated bone marrow mononuclear cells (BMMC) following an acute ST-elevation myocardial infarction. Peripheral blood mononuclear cells or enriched CD133(+) BMMC have been associated with accelerated atherosclerosis of the distal segment of the infarct related artery (IRA). Thirty-seven patients with ST-elevation myocardial infarction from the TECAM pilot study underwent intracoronary infusion of autologous BMMC 9 +/- 3.1 days after onset of symptoms. We compared angiographic changes from baseline to 9 months of follow-up in the distal non-stented segment of the IRA, as well as in the contralateral coronary artery, with a matched control group. A subgroup of 15 treated patients underwent additional IVUS within the distal segment of the IRA. No difference between stem cell and control group were found regarding changes in minimum lumen diameter (0.006 +/- 0.42 vs 0.06 +/- 0.41 mm, P = ns) and the percentage of stenosis (-2.68 +/- 12.33% vs -1.78 +/- 8.75%, P = ns) at follow-up. Likewise, no differences were seen regarding changes in the contralateral artery (minimum lumen diameter -0.004 +/- 0.54 mm vs -0.06 +/- 0.35 mm, P = ns). In the intravascular ultrasound substudy, no changes were demonstrated comparing baseline versus follow-up in maximum area stenosis and plaque volume. In this pilot study, analysis of a subgroup of patients found that intracoronary injection of unfractionated BMMC in patients with acute ST-elevation myocardial infarction was not associated with accelerated atherosclerosis progression at mid term. Prospective, randomised studies in large cohorts with long-term angiographic and intravascular ultrasound follow-up are necessary to determine the safety of this therapy. Copyright 2010 Mosby, Inc. All rights reserved.

Pre-sarcopenia and bone mineral density in adults submitted to hematopoietic stem cell transplantation.

PubMed

Pereira, Cristiane Pavan; Amaral, Denise Johnsson Campos; Funke, Vaneuza Araujo Moreira; Borba, Victória Zeghbi Cochenski

The aim of this study was to evaluate the prevalence of pre-sarcopenia and bone mineral density after hematopoietic stem cell transplantation. The study group consisted of over 18-year-old patients who had been submitted to allogeneic transplantation at least one year previously. Patients and healthy controls were matched by sex, ethnic background, age, and body mass index. Body composition and bone mineral density were measured by dual-energy X-ray absorptiometry. A 24-h food recall and food frequency survey were performed. The biochemical evaluation included calcium, parathormone and vitamin D. Eighty-seven patients (52 men; age: 37.2±12.7 years; body mass index: 25±4.5kg/m 2 ) were compared to 68 controls [31 men; age 35.4±15.5 years (p=0.467); body mass index 25.05±3.7kg/m 2 (p=0.927)]. There was no significant difference in the dietary intake between patients and controls. The mean levels of vitamin D were 23.5±10.3ng/mL; 29 patients (41.0%) had insufficient and 26 (37.14%) deficient levels. A higher prevalence of reduced bone mineral density was observed in 24 patients (25%) compared to 12 controls (19.1% - p<0.001). Pre-sarcopenia was diagnosed in 14 (14.4%) patients and none of the controls (p=0.05). There was a higher prevalence of pre-sarcopenia (66%) in patients with grades III and IV compared to those with grades 0-II graft-versus-host disease (10.9%) (p=0.004). patients submitted to transplantation had a higher prevalence of pre-sarcopenia and greater changes in bone mineral density compared to controls; the severity of graft-versus-host disease had an impact on the prevalence of pre-sarcopenia. Copyright © 2017 Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular. Published by Elsevier Editora Ltda. All rights reserved.

Terapia fibrinolítica sistêmica no tromboembolismo pulmonar

PubMed Central

Ceresetto, José Manuel; Marques, Marcos Arêas

2017-01-01

Resumo O tromboembolismo pulmonar permanece como um grande desafio terapêutico para os médicos especialistas, pois, apesar de todo investimento e desenvolvimento em seu diagnóstico, profilaxia e tratamento, essa condição continua sendo a principal causa de morte evitável em ambiente hospitalar. Ainda restam muitas dúvidas em relação a qual perfil de paciente vai se beneficiar de fato da terapia fibrinolítica sistêmica, sem ficar exposto a um grande risco de sangramento. A estratificação de risco e a avaliação do prognóstico do evento, através de escores clínicos de insuficiência ventricular direita, marcadores de dilatação e disfunção do ventrículo direito e avaliação da massa trombótica, associados ou de forma isolada, são ferramentas que podem auxiliar na identificação do paciente que irá se beneficiar dessa terapia. Os únicos consensos em relação à terapia fibrinolítica no tratamento do tromboembolismo pulmonar são: não deve ser indicada de forma rotineira; nenhum dos escores ou marcadores, isoladamente, devem justificar seu uso; e os pacientes com instabilidade hemodinâmica são os mais beneficiados. Além disto, deve-se avaliar cada caso em relação ao risco de sangramento, especialmente no sistema nervoso central. PMID:29930636

Low-level laser therapy and Calendula officinalis in repairing diabetic foot ulcers.

PubMed

Carvalho, Ana Flávia Machado de; Feitosa, Maura Cristina Porto; Coelho, Nayana Pinheiro Machado de Freitas; Rebêlo, Veruska Cronemberger Nogueira; Castro, Juçara Gonçalves de; Sousa, Patrícia Regina Gomes de; Feitosa, Valrian Campos; Arisawa, Emilia Angela Lo Schiavo

2016-01-01

To evaluate the effects of low-level laser therapy isolated and associated with Calendula officinalis oil in treating diabetic foot ulcers. An experimental, randomized, controlled, prospective, interventional clinical case study using a quantitative approach. The sample consisted of 32 diabetic patients of both genders. Participants were randomly divided into four groups. Doppler Ultrasound evaluation of the Ankle-Brachial Index, brief pain inventory and analog pain scale were performed at baseline and after 30 days. Reduced pain was observed in the Low-level laser therapy and Low-level laser therapy associated with Essential Fatty Acids groups (p<0.01). Regarding the Ankle-Brachial Index and Doppler Ultrasound, all groups remained stable. By analyzing lesion area reduction, Low-level laser therapy associated with Essential fatty acids group showed a significance of p=0.0032, and the Low-level laser therapy group showed p=0.0428. Low-level laser therapy, performed alone or associated with the Calendula officinalis oil was effective in relieving pain and accelerating the tissue repair process of diabetic foot. Avaliar os efeitos da Terapia a Laser de Baixa Intensidade isolada e associada ao óleo de Calendula officinalis no reparo de úlceras em pé diabético. Estudo de caso clínico, experimental, controlado, randomizado, prospectivo, intervencional, de caráter quantitativo. A amostra foi composta de 32 pacientes diabéticos, de ambos os gêneros. Os participantes foram distribuídos aleatoriamente em quatro grupos. Ultrassom Doppler, avaliação do Índice Tornozelo-Braquial, Inventário breve de dor e escala de dor analógica foram realizados no início e após 30 dias. Houve redução da dor nos grupos Terapia a Laser de Baixa Intensidade e Terapia a Laser de Baixa intensidade associada aos Ácidos Graxos Essenciais, com p<0,01. Quanto ao Índice Tornozelo-Braquial e Ultrassom Doppler, todos os grupos mantiveram-se estáveis. Na análise da redução de área da lesão, o grupo Terapia a Laser de Baixa Intensidade associada aos Ácidos Graxos Essenciais apresentou uma significância p=0,0032, e o grupo Terapia a Laser de Baixa Intensidade, p=0,0428. A Terapia a Laser de Baixa Intensidade, realizada tanto isoladamente quanto associada ao óleo de Calendula officinalis, foi eficaz no alívio da dor e na aceleração do processo de reparo tecidual de pé diabético.

Dangerous universal donors: the reality of the Hemocentro in Belo Horizonte, Minas Gerais.

PubMed

Godin, Mariana Martins; Souza, Lucas de Oliveira; Schmidt, Luciana Cayres; Vieira, Lauro Mello; Diniz, Rejane Silva; Dusse, Luci Maria SantAna

2016-01-01

The term dangerous universal blood donor refers to potential agglutination of the erythrocytes of non-O recipients due to plasma of an O blood group donor, which contains high titers of anti-A and/or anti-B hemagglutinins. Thus, prior titration of anti-A and anti-B hemagglutinins is recommended to prevent transfusion reactions. The aim of this study was to estimate the frequency of dangerous universal donors in the blood bank of Belo Horizonte (Fundação Central de Imuno-Hematologia - Fundação Hemominas - Minas Gerais) by determining the titers of anti-A and anti-B hemagglutinins in O blood group donors. A total of 400 O blood group donors were randomly selected, from March 2014 to January 2015. The titers of anti-A and anti-B hemagglutinins (IgM and IgG classes) were obtained using the tube titration technique. Dangerous donors were those whose titers of anti-A or anti-B IgM were ≥128 and/or the titers of anti-A or anti-B IgG were ≥256. Donors were characterized according to gender, age and ethnicity. The hemagglutinins were characterized by specificity (anti-A and anti-B) and antibody class (IgG and IgM). Almost one-third (30.5%) of the O blood group donors were universal dangerous. The frequency among women was higher than that of men (p-value=0.019; odds ratio: 1.66; 95% confidence interval: 1.08-2.56) and among young donors (18-29 years old) it was higher than for donors between 49 and 59 years old (p-value=0.015; odds ratio: 3.05; 95% confidence interval: 1.22-7.69). There was no significant association between dangerous universal donors and ethnicity, agglutinin specificity or antibody class. Especially platelet concentrates obtained by apheresis (that contain a substantial volume of plasma), coming from dangerous universal donors should be transfused in isogroup recipients whenever possible in order to prevent the occurrence of transfusion reactions. Copyright © 2016 Associação Brasileira de Hematologia, Hemoterapia e Terapia Celular. Published by Elsevier Editora Ltda. All rights reserved.

PubMed

Scotta, Ana Verónica; Bongiovanni, Guillermina Azucena; Soria, Elio Andrés

2018-03-21

Antecedentes: Clorpirifos es un pesticida altamente tóxico, que puede producir inmunotoxicidad con efectos deletéreos sobre la salud a nivel mundial. Por otro lado, las plantas americanas pueden tener derivados con actividad protectora e inmunoestimulante. Por lo tanto, debe evaluarse el potencial de estas plantas frente a clorpirifos. Objetivo: Identificar extractos acuosos bioactivos de Lantana grisebachii (LG), Aspidosperma quebracho-blanco (AQ), Peumus boldus (PB), e Ilex paraguariensis (IP), contra la toxicidad de clorpirifos sobre esplenocitos de hembras Balb/c. Materiales y Métodos: Esplenocitos fueron tratados in vitro por 72 horas con 0-35 µg/mL de clorpirifos, 0-100 µg/mL de cada extracto (LG, AQ, PB, IP) y 0-5 µg/mL de concanavalina A. Luego, se midió y analizó estadísticamente viabilidad y muerte celular (tinciones de resazurina y yoduro de propidio), hidroperóxidos, lipoperóxidos (ensayos basados en naranja de xilenol), actividad de la ?-glutamiltranspeptidasa (método de Szasz). Resultados: Clorpirifos redujo la viabilidad celular de forma dosis dependiente, lo que fue contrarrestado por AQ e IP, los que fueron menos activos en las células inducibles por concanavalina A (p<0,05). La toxicidad por clorpirifos implicó la inducción de la ?-glutamiltranspeptidasa con la consecuente reducción de los peróxidos, mientras que AQ y principalmente IP antagonizaron dichas respuestas (p<0,05). Conclusiones: Los extractos de Ilex paraguariensis y Aspidosperma quebracho-blanco protegieron in vitro a los esplenocitos frente a clorpirifos. Este efecto dependió del tipo celular, dado que las células inducibles por concanavalina A fueron más susceptibles a este tóxico.

MANAGEMENT OF ACUTE SEVERE ULCERATIVE COLITIS: A CLINICAL UPDATE.

PubMed

Sobrado, Carlos Walter; Sobrado, Lucas Faraco

2016-01-01

Acute severe colitis is a potentially lethal medical emergency and, even today, its treatment remains a challenge for clinicians and surgeons. Intravenous corticoid therapy, which was introduced into the therapeutic arsenal in the 1950s, continues to be the first-line treatment and, for patients who are refractory to this, the rescue therapy may consist of clinical measures or emergency colectomy. To evaluate the indications for and results from drug rescue therapy (cyclosporine, infliximab and tacrolimus), and to suggest a practical guide for clinical approaches. The literature was reviewed using the Medline/PubMed, Cochrane library and SciELO databases, and additional information from institutional websites of interest, by cross-correlating the following keywords: acute severe colitis, fulminating colitis and treatment. Treatments for acute severe colitis have avoided colectomy in 60-70% of the cases, provided that they have been started early on, with multidisciplinary follow-up. Despite the adverse effects of intravenous cyclosporine, this drug has been indicated in cases of greater severity with an imminent risk of colectomy, because of its fast action, short half-life and absence of increased risk of surgical complications. Therapy using infliximab has been reserved for less severe cases and those in which immunosuppressants are being or have been used (AZA/6-MP). Indication of biological agents has recently been favored because of their ease of therapeutic use, their good short and medium-term results, the possibility of maintenance therapy and also their action as a "bridge" for immunosuppressant action (AZA/6-MP). Colectomy has been reserved for cases in which there is still no response five to seven days after rescue therapy and in cases of complications (toxic megacolon, profuse hemorrhage and perforation). Patients with a good response to rescue therapy who do not undergo emergency operations should be considered for maintenance therapy using azathioprine. A surgical procedure is indicated for selected cases. A colite aguda grave é emergência médica, potencialmente letal e o seu tratamento permanece ainda nos dias de hoje um desafio para o clínico e cirurgião. A corticoterapia intravenosa introduzida no arsenal terapêutico na década de 50 permanece como primeira linha de tratamento, e nos pacientes refratários a tal medida, a terapia de resgate pode ser com medidas clínicas ou colectomia de urgência. Avaliar os resultados da terapia de resgate medicamentosa (ciclosporina, infliximabe e tracolimus), suas indicações e resultados, e sugerir um guia prático para abordagem clínica. Foi realizada revisão na literatura utilizando as bases Medline/Pubmed, Cochrane Library, Scielo, e informações adicionais em sites institucionais de interesse cruzando os descritores: colite aguda grave, colite fulminante e tratamento. O tratamento da colite aguda grave tem evitado a colectomia em 60- 70% dos casos, desde que iniciado precocemente e com acompanhamento multidisciplinar. A ciclosporina intravenosa apesar de seus efeitos adversos, tem sido indicada naqueles casos mais graves com risco iminente de colectomia, pela sua rapidez de ação, meia-vida curta, e não aumentar os riscos de complicações cirúrgicas. A terapia com infliximabe tem sido reservada para os casos menos graves e naqueles em uso ou já expostos a imunossupressores (AZA/6-MP). A facilidade terapêutica, seus bons resultados a curto e médio prazo, a possibilidade de terapia de manutenção e também por agir como "ponte" para ação de imunossupressores (AZA/6-MP) tem recentemente favorecido a indicação de biológicos. A colectomia fica reservada para casos que não apresentaram resposta a terapia de resgate após cinco a sete dias de tratamento e nas complicações (megacólon tóxico, hemorragia profusa e perfuração). s: Os pacientes com boa resposta à terapia de resgate e não submetidos à operações de urgência, deverão ser considerados para terapia de manutenção com azatioprina, sendo procedimento cirúrgico indicado para casos selecionados.

RETOS EN LA INTERVENCIÓN CON ADOLESCENTES PUERTORRIQUEÑOS/AS QUE MANIFIESTAN COMPORTAMIENTO SUICIDA*

PubMed Central

Vélez, Yovanska Duarté; Dávila, Paloma Torres; Hernández, Samariz Laboy

2015-01-01

Presentamos un estudio de caso de una adolescente puertorriqueña con comportamiento suicida. Esta comenzó una Terapia Socio Cognitivo-Conductual para el Comportamiento Suicida (TSCC-CS) de tipo ambulatorio luego de una hospitalización por intento suicida. La TSCC-CS incorpora una perspectiva ecológica y de desarrollo a la terapia cognitivo-conductual. Inicialmente mostró baja autoestima y severos síntomas depresivos y de ansiedad. Al finalizar el tratamiento, manifestó un cambio significativo en su sintomatología clínica y evidenció una mejoría en sus destrezas de manejo. No presentó ideas suicidas durante meses previos, ni durante el seguimiento. El análisis de este caso permitió realizar cambios en el protocolo de tratamiento, particularmente en las sesiones de familia y de comunicación con el fin de aumentar la viabilidad del tratamiento. PMID:26702337

Biophysical and Biochemical Mechanisms in Synaptic Transmitter Release.

DTIC Science & Technology

1992-01-31

vesicle is normally released per active zone Sci USA 83. 3032 (1986) pared (15, 19, 20). In fact, in squid, the quantum 8 0 Shimomura 8 Musicki. V Kisni...8217, AND R. LLINAS• *Instituto de Biologia Celular Facultad de Medicina. Universidad de Buenos Aires. Paraguay 2155. Buenos Aires 1121. Argentina: and

Effect of the inclusion of mobile phone interviews to Vigitel.

PubMed

Bernal, Regina Tomie Ivata; Malta, Deborah Carvalho; Claro, Rafael Moreira; Monteiro, Carlos Augusto

2017-06-01

To evaluate the impact on the prevalence changes of risk factors for chronic diseases, published in the Surveillance System of Risk and Protection Factors for Chronic Diseases by Telephone Survey (Vigitel), after the inclusion of data from the population only with mobile phone. Our study used data from the 26 State capitals and Federal District of Brazil obtained by the National Survey on Health (PNS) and Vigitel, both held in 2013. In each capital, we added a subsample of 200 adults living in households with only mobile phones, extracted from PNS, to the Vigitel 2013 database, with approximately 1,900 households, named Vigitel dual frame. Vigitel results showed absolute relative biases between 0.18% and 14.85%. The system underestimated the frequency of adult smokers (10.77%), whole milk consumption (52.82%), and soft drink consumption (22.22%). Additionally, it overestimated the prevalence of hypertension (25.46%). In the simulations using Vigitel dual frame, with inclusion of the sample of adults living in households with only mobile phones, the bias of estimates was reduced in five out of eight analyzed indicators, with greater effects in regions with lower rates of landline coverage. In comparing regions, we observed negative correlation (ρ = -0.91) between the percentage of indicators with presence of bias and the percentage of households with only mobile phone. The results of this study indicate the benefits of including a subsample of 200 adults with only mobile phone on the Vigitel sample, especially in the capitals of the North and Northeast regions. Avaliar o impacto nas mudanças das prevalências de fatores de risco de doenças crônicas, divulgadas no Vigitel, após a inclusão de dados provenientes da população com somente telefone celular. O estudo utilizou os dados das capitais obtidos da Pesquisa Nacional de Saúde e do Vigitel, que foram realizados em 2013. Em cada capital, acrescentou-se uma subamostra de 200 adultos residentes em domicílios com somente celular, extraída da PNS, à base de dados do Vigitel 2013, com aproximadamente 1.900 domicílios, denominado Vigitel cadastro duplo. Os resultados do Vigitel mostraram vícios relativos absolutos entre 0,18% e 14,85%. O sistema subestimou a frequência de adultos fumantes (10,77%), o consumo de leite com teor integral de gordura (52,82%) e o consumo de refrigerante (22,22%). Adicionalmente, superestimou a prevalência de hipertensão (25,46%). Nas simulações utilizando o Vigitel cadastro duplo, com inclusão da amostra de adultos residentes em domicílios com somente celular, o vício das estimativas foi reduzido em cinco de oito indicadores analisados, com maiores efeitos nas regiões com menores taxas de cobertura de telefonia fixa. Na comparação entre as regiões, observa-se correlação negativa (ρ = -0,91) entre o percentual de indicadores com presença de vício e o percentual de cobertura de domicílios com somente celular. Os resultados do presente estudo indicam os benefícios da inclusão de uma subamostra de 200 adultos com somente celular na amostra do Vigitel, especialmente nas capitais das regiões Norte e Nordeste.

Nursing Activities Score and Acute Kidney Injury.

PubMed

Coelho, Filipe Utuari de Andrade; Watanabe, Mirian; Fonseca, Cassiane Dezoti da; Padilha, Katia Grillo; Vattimo, Maria de Fátima Fernandes

2017-01-01

to evaluate the nursing workload in intensive care patients with acute kidney injury (AKI). A quantitative study, conducted in an intensive care unit, from April to August of 2015. The Nursing Activities Score (NAS) and Kidney Disease Improving Global Outcomes (KDIGO) were used to measure nursing workload and to classify the stage of AKI, respectively. A total of 190 patients were included. Patients who developed AKI (44.2%) had higher NAS when compared to those without AKI (43.7% vs 40.7%), p <0.001. Patients with stage 1, 2 and 3 AKI showed higher NAS than those without AKI. A relationship was identified between stage 2 and 3 with those without AKI (p = 0.002 and p <0.001). The NAS was associated with the presence of AKI, the score increased with the progression of the stages, and it was associated with AKI, stage 2 and 3. avaliar a carga de trabalho de enfermagem em pacientes de terapia intensiva com lesão renal aguda (LRA). estudo quantitativo, em Unidade de Terapia Intensiva, no período de abril a agosto de 2015. O Nursing Activities Score (NAS) e o Kidney Disease Improving Global Outcomes (KDIGO) foram utilizados para medir a carga de trabalho de enfermagem e classificar o estágio da LRA, respectivamente. foram incluídos 190 pacientes. Os pacientes que desenvolveram LRA (44,2%) possuíam NAS superiores quando comparados aos sem LRA (43,7% vs 40,7%), p<0,001. Os pacientes com LRA nos estágios 1, 2 e 3 de LRA demonstraram NAS superiores aos sem LRA, houve relação entre os estágios 2 e 3 com os sem LRA, p=0,002 e p<0,001. o NAS apresentou associação com a existência de LRA, visto que seu valor aumenta com a progressão dos estágios, tendo associação com os estágios 2 e 3 de LRA.

The International Cytokine Conference (11th) Held in Dublin (Ireland) on September 20-24 2003 (European Cytokine Network, Volume 14, Number 3, September 2003)

DTIC Science & Technology

2003-09-01

Fisiologia Celular UNAM, Mexico City/ Mexico specific marker of bacterial sepsis. Despite the increasing clinical importance of PCT the knowledge about its...about their function or scription factor NF-kappaB. Likewise, Varicella -zoster virus strongly mechanism of action. activates the AP- 1 components Jun and

[Trattamento del disturbo da uso di alcol da un punto di vista psicologico].

PubMed

Coriale, Giovanna; Fiorentino, Daniela; De Rosa, Francesca; Solombrino, Simona; Scalese, Bruna; Ciccarelli, Rosaria; Attilia, Fabio; Vitali, Mario; Musetti, Alessia; Fiore, Marco; Ceccanti, Mauro

2018-01-01

RIASSUNTO. L'elaborazione del piano di trattamento rappresenta un momento molto delicato e complesso del processo terapeutico del disturbo da abuso di alcol (DUA). È la fase in cui le informazioni raccolte da un'équipe di professionisti (medici, psicologi e assistenti sociali) (modello bio-psico-sociale del DUA) vengono messe insieme per decidere il percorso terapeutico più adatto. Per quanto riguarda la parte psicologica, è di notevole importanza scegliere un trattamento clinico in grado di ridurre al minimo la mancata adesione al trattamento e, per i soggetti che rimangono in trattamento, di garantirne l'efficacia. Se da una parte, le tecniche psicoanalitiche e comportamentali hanno fornito le basi della terapia psicologica dell'alcolismo, dall'altra, gli approcci basati sull'evidenza scientifica sono stati elaborati a partire dai principi del colloquio motivazionale e della terapia cognitivo-comportamentale. In questo articolo viene fornita una panoramica dei trattamenti che sono risultati più efficaci nel trattare il DUA e delle modalità temporali più adeguate per monitorare l'efficacia del trattamento.

Effects of dignity therapy on terminally ill patients: a systematic review.

PubMed

Donato, Suzana Cristina Teixeira; Matuoka, Jéssica Yumi; Yamashita, Camila Cristófero; Salvetti, Marina de Goés

2016-01-01

Analyzing the evidence of the effects of dignity therapy onterminally ill patients. A Systematic review of the literature conducted using the search strategy in six databases. Inclusion criteria were primary studies, excluding literature reviews (systematic or not) and conceptual articles. Ten articles were analyzed regarding method, results and evidence level. Dignity therapy improved the sense of meaning andpurpose, will to live, utility, quality of life, dignity and family appreciationin studies with a higher level of evidence. The effects are not well established in relation to depression, anxiety, spirituality and physical symptoms. Studies with a moderate to high level of evidence have shown increased sense of dignity, will to live and sense of purpose. Further studies should be developed to increase knowledge about dignity therapy. Analisar as evidências sobre os efeitos da terapia da dignidade para pacientes em fase terminal de vida. Revisão sistemática da literatura realizada em seis bases de dados na estratégia de busca. Os critérios de inclusão foram estudos primários, excluindo-se revisões da literatura (sistemáticas ou não) e artigos conceituais. Dez artigos foram analisados quanto ao método, aos resultados e nível de evidência. Nos estudos com maior nível de evidência, a terapia da dignidade melhorou o senso de significado, propósito, vontade de viver, utilidade, qualidade de vida, dignidade e apreciação familiar.Os efeitos não estão bem estabelecidos em relação à depressão, ansiedade, espiritualidade e aos sintomas físicos. Os estudos de nível de evidência de moderado a alto demonstraram aumento do senso de dignidade, vontade de viver e senso de propósito. Mais estudos devem ser desenvolvidos para ampliar o conhecimento sobre a terapia da dignidade.

Fire-retardant foams

NASA Technical Reports Server (NTRS)

Gagliani, J.

1978-01-01

Family of polyimide resins are being developed as foams with exceptional fire-retardant properties. Foams are potentially useful for seat cushions in aircraft and ground vehicles and for applications such as home furnishings and building-construction materials. Basic formulations can be modified with reinforcing fibers or fillers to produce celular materials for variety of applications. By selecting reactants, polymer structure can be modified to give foams with properties ranging from high resiliency and flexibility to brittleness and rigidity.

Impact of neoadjuvant therapy in downstaging of lower rectal adenocarcinoma and the role of pelvic magnetic resonance in staging.

PubMed

Magri, Karina Dagre; Bin, Fang Chia; Formiga, Fernanda Bellotti; Manzione, Thiago da Silveira; Gomes, Caroline Merci Caliari de Neves; Candelári, Paulo de Azeredo Passos; Ortiz, Jorge Alberto; Klug, Wilmar Artur; Mandia, José; Capelhuchnik, Peretz

2016-01-01

to evaluate the effect of neoadjuvant therapy on the stage (TNM) of patients with rectal adenocarcinoma and validate the use of MRI as a method of determining locoregional stage. we conducted a retrospective study of 157 patients with lower rectum adenocarcinoma, whom we divided into two groups: Group 1, 81 patients (52%) who had undergone surgical treatment initially, with the purpose to analyze the accuracy of locoregional staging by pelvic magnetic resonance imaging throug the comparison of radiological findings with pathological ones; Group 2, 76 patients (48%), who had been submitted to neoadjuvant therapy (chemotherapy and radiation) prior to definitive surgical treatment, so as to evaluate its effects on the stage by comparing clinical and radiological findings with pathology. In group 1, the accuracy of determining tumor depth (T) and lymph node involvement (N) was 91.4% and 82.7%, respectively. In group 2, neoadjuvant therapy decreased the T stage, N stage and TNM stage in 51.3%, 21% and 48.4% of cases, respectively. neoadjuvant therapy in patients with rectal adenocarcinoma is effective in decreasing disease stage, and pelvic magnetic resonance imaging is effective for locoregional staging. avaliar o efeito da terapia neoadjuvante, nos pacientes portadores de adenocarcinoma de reto, sobre o estádio (TNM) e validar o emprego da ressonância magnética como método de determinação do estádio locorregional. estudo retrospectivo de 157 pacientes com diagnóstico de adenocarcinoma de reto baixo, que foram divididos em dois grupos: Grupo 1, 81 pacientes (52%), submetidos ao tratamento cirúrgico de princípio, cuja finalidade foi analisar a acurácia da determinação do estádio locorregional pela ressonância magnética da pelve, através da comparação entre os achados radiológicos e os achados anatomopatológicos; Grupo 2, 76 pacientes (48%), encaminhados à terapia neoadjuvante (quimioterapia e radioterapia), antes do tratamento cirúrgico definitivo, com o intuito de avaliar seus efeitos sobre o estádio, através da comparação dos achados clínico-radiológicos com os anatomopatológicos. no grupo 1, a acurácia da determinação da profundidade da lesão (T) e do comprometimento linfonodal (N), foram de 91,4% e 82,7%, respectivamente. No grupo 2, a terapia neoadjuvante diminuiu o estádio T, estádio N e o estádio TNM em 51,3%, 21% e 48,4% dos casos, respectivamente. a terapia neoadjuvante nos pacientes com adenocarcinoma de reto é efetiva na diminuição do estádio e a ressonância magnética da pelve é eficaz na determinação do estádio locorregional.

Fidelity of DNA Replication in Normal and Malignant Human Breast Cells.

DTIC Science & Technology

1997-08-01

enzyme) into the multiple cloning site (MCS). This template will not only replicate inside a mammalian cell (utilizing the E-B virus origin), and...Maniatis, T. Commonly used techniques in molecular cloning . In: Molecular cloning : REFERENCES a laboratory manual, 2nd edition. Cold Spring Harbor...A vatit"Y Of DNA synthesis and the typt of DNA replica~tion Products " celular prca including DNA rsplicatlon. DNA repsair. R~NA formed in experiments

Actions of Interferons on Macrophages.

DTIC Science & Technology

1984-06-01

cell productin celular immunity. The following is a list of our accomplishments. 1. The successful immunization of rats with a partially purified IFNy...antibbdy (MAb) was cloned . 3. The hybridoma producing rat anti-MuiFN*MAb has proven stable and is being propagated both in vitro and as well as in vivo in...containing 20% FBS. The cloned hybridoma (R4-6A2) was expanded and the isotype of monoclonal antibody (MAb) produced by this clone was determined to be in

Riego y fertirriego

Treesearch

R. Kasten Dumroese; Thomas D. Landis; Kim M. Wilkinson

2012-01-01

El agua es el factor que más puede afectar el crecimiento y la sanidad de las plantas por sí solo. Es esencial para casi todos los procesos vegetales: la fotosíntesis, el transporte de nutrientes, el crecimiento y el desarrollo celular. De hecho, del 80 al 90% del peso de un plantín es agua, por lo cual el manejo del riego es una de las tareas más trascendentes dentro...

[Post-partum thyroiditis].

PubMed

Neves, Celestino; Alves, Marta; Delgado, Luís; Medina, J Luís

2009-01-01

In the post-partum period the immune alterations are associated with the multiple autoimmune diseases relapse. After birth, immune-tolerance variation slowly disappear, and is observed a return to a normal state - after an exacerbation period - of autoimmune reactivity, during which a great increase in T cells and autoantibodies is observed. In this period - 3 to 9 months after birth - the thyroid autoimmune disease relapses or reappears. The reactivation of the immune system in the post-partum period unchains an acute phase of celular destruction which characterizes the post-partum thyroiditis.

Host Defense Against Opportunist Microorganisms Following Trauma

DTIC Science & Technology

1989-06-30

the cAMP content of PMNs from injured and normal animals was com- pared . In addition, the effect of treatment with NSAIDs and cAMP activa- tors on...demonstrated that peripheral and peritoneal exudate PMNs from injured animals had a marked elevation of cAMP as com- pared with similar PMN preparations from...Measurement of rates of phagocytosis: the use of celular monolayers. J. Cell Biol. 40:216. 27. Bjornson, A. B., P. I. Magnafichi, R. D. Schreiber, and H. S

Uso de curativo a vácuo como terapia adjuvante na cicatrização de sítio cirúrgico infectado

PubMed Central

de Camargo, Paula Angeleli Bueno; Bertanha, Matheus; Moura, Regina; Jaldin, Rodrigo Gibin; Yoshida, Ricardo de Alvarenga; Pimenta, Rafael Elias Farres; Mariúba, Jamil Victor de Oliveira; Sobreira, Marcone Lima

2016-01-01

Resumo Infecções de sítios cirúrgicos com envolvimento de próteses sintéticas constituem grande desafio para tratamento. Apresentamos o caso de uma paciente com múltiplas comorbidades, histórico de enxerto aortobifemoral há 6 anos e reabordagem das anastomoses femorais por reestenoses há 5 anos. Apresentou dor inguinal esquerda e abaulamento súbitos com diagnóstico de pseudoaneurisma femoral roto e instabilidade hemodinâmica. Foi submetida a correção emergencial com interposição de prótese de dácron recoberta por prata e correção de grande hérnia incisional abdominal com tela sintética ao mesmo tempo. No pós-operatório, manteve-se por longo período sob terapia intensiva com dificuldade de extubação. Nesse ínterim, apresentou deiscência das suturas e fístula purulenta inguinal esquerda em contato com a prótese vascular. Optou-se pelo tratamento conservador, com desbridamento das feridas e aplicação de curativo a vácuo. A paciente evoluiu com melhora e cicatrização das feridas. Essa pode se constituir em ferramenta importante em casos similares.

Use of 70 MeV Proton Beam for Medical Applications at INFN-LNS: CATANA Project

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sabini, M.G.; Cirrone, G.A.P.; Barone Tonghi, L.

The project CATANA (Centro di AdroTerapia ed Applicazioni Nucleari Avanzate) is a collaboration between the INFN-Laboratori Nazionali del Sud (LNS), Physics Department, Ophthalmology Institute and Radiology Institute of the Catania University and CSFNSM Catania. The main goal of CATANA is the study and the application of proton therapy for the treatment of shallow tumors (4 cm max) like uveal melanomas and subfoveal macular degenerations.

Use of 70 MeV proton beam for medical applications at INFN-LNS: CATANA project

NASA Astrophysics Data System (ADS)

Sabini, M. G.; Cirrone, G. A. P.; Tonghi, L. Barone; Bartolotta, A.; Brai, M.; Cuttone, G.; Nigro, S. Lo; Marano, F.; Nicoletti, G. A.; Privitera, G.; Raffaele, L.; Reibaldi, A.; Romeo, N.; Rovelli, A.; Salamone, V.; Teri, G.

2000-04-01

The project CATANA (Centro di Adro Terapia ed Applicazioni Nucleari Avanzate) is a collaboration between the INFN-Laboratori Nazionali del Sud (LNS), Physics Department, Ophthalmology Institute and Radiology Institute of the Catania University and CSFNSM Catania. The main goal of CATANA is the study and the application of protontherapy for the treatment of shallow tumors (4 cm max) like uveal melanomas and subfoveal macular degenerations.

Computerized nursing process in the Intensive Care Unit: ergonomics and usability.

PubMed

Almeida, Sônia Regina Wagner de; Sasso, Grace Teresinha Marcon Dal; Barra, Daniela Couto Carvalho

2016-01-01

Analyzing the ergonomics and usability criteria of the Computerized Nursing Process based on the International Classification for Nursing Practice in the Intensive Care Unit according to International Organization for Standardization(ISO). A quantitative, quasi-experimental, before-and-after study with a sample of 16 participants performed in an Intensive Care Unit. Data collection was performed through the application of five simulated clinical cases and an evaluation instrument. Data analysis was performed by descriptive and inferential statistics. The organization, content and technical criteria were considered "excellent", and the interface criteria were considered "very good", obtaining means of 4.54, 4.60, 4.64 and 4.39, respectively. The analyzed standards obtained means above 4.0, being considered "very good" by the participants. The Computerized Nursing Processmet ergonomic and usability standards according to the standards set by ISO. This technology supports nurses' clinical decision-making by providing complete and up-to-date content for Nursing practice in the Intensive Care Unit. Analisar os critérios de ergonomia e usabilidade do Processo de Enfermagem Informatizado a partir da Classificação Internacional para as Práticas de Enfermagem, em Unidade de Terapia Intensiva, de acordo com os padrões da InternationalOrganization for Standardization (ISO). Pesquisa quantitativa, quase-experimental do tipo antes e depois, com uma amostra de 16 participantes, realizada em uma Unidade de Terapia Intensiva. Coleta de dados realizada por meio da aplicação de cinco casos clínicos simulados e instrumento de avaliação. A análise dos dados foi realizada pela estatística descritiva e inferencial. Os critérios organização, conteúdo e técnico foram considerados "excelentes", e o critério interface "muito bom", obtendo médias 4,54, 4,60, 4,64 e 4,39, respectivamente. Os padrões analisados obtiveram médias acima de 4,0, sendo considerados "muito bons" pelos participantes. O Processo de Enfermagem Informatizado possui padrões ergonômicos e de usabilidade de acordo com os padrões estabelecidos pela ISO. Esta tecnologia apoia a decisão clínica do enfermeiro fornecendo conteúdo completo e atualizado para a prática de Enfermagem em Unidade de Terapia Intensiva.

Unusual Bloom of Tetraselmis sp. in the Valparaiso Bay, Chile

DTIC Science & Technology

2012-01-01

Universidad Técnica Federico Santa María, Sede Viña del Mar, Chile (33º02`05.50``S; 71º35`44.54``O). Los datos de magnitud – dirección del viento por la...λ (nm) 372 Gayana Bot. 69(2), 2012 AGRADECIMIENTOS A Gloria Collantes por identificación del género Tetraselmis. Universidad Técnica Federico Santa...Tetraselmis sp. pudo ser el factor excluyente de las especies de diatomeas, permitiendo alcanzar una alta densidad celular, debido al rápido consumo

[Immunological status of patients with amebic hepatic abscess].

PubMed

Canto Solís, A; Miranda Feria, A J; Medina Martinez, J; Teran Ortíz, L A; Suárez Sánchez, F

1975-01-01

The authors studied 10 cases of amoebic hepatic abscess documented by clinical evidence and confirmed by laboratory tests, liver scan and a good response to treatment. The immunological state of the patients was determined by protein electrophoresis, immunoelectrophoresis, counter-immunoelectrophoresis, radial immunodiffusion and roset formation for T and B lymphocytes. It is concluded that the alterations of cellular and humoral immunity is evident in cases of amoebic hepatic abscess; this alterations are more clear in the acute form of the illness and the immunological deficiency is more significant in the celular immunity.

[Effect of indolylacetic acid on formation of bacteroid forms of Rhizobium leguminosarum].

PubMed

Lobanok, E V; Bakanchikova, T I

1979-01-01

The purpose of this work was to study the effect of indolylacetic acid (IAA) on the strains of Rhizobium leguminosarum, effective and noneffective with respect to symbiotic nitrogen fixation (L4 and 245a, and 14--73, respectively). IAA at a concentration of 50 mcg/ml and higher inhibited the growth of the bacterium, temporarily delayed celular division, and induced intensive formation of elongated bacteroid-like cells, predominantly Y-shaped or having a clavate shape. Many bacteroid-like cells were capable of division after a certain delay.

[Familial retinoblastoma: cytogenetic study of the tumor].

PubMed

Robledo Batanero, M; Manzanal Martínez, A; Ayuso García, C; Benítez Ortiz, J

1990-05-01

We report a case of familiar retinoblastoma, in which both mother and daughter show bilateral retinoblastoma. The cytogenetic study, in both peripheral blood lymphocytes and tumoral tissue did not show alterations on the 13 chromosome, although we found a complex kariotype in tumoral tissue defined by three celular lines. In all of them appears a marker in which the 6 chromosome is involved (der 6). The derivated of 6 chromosome are markers highly characteristic of the retinoblastoma cases, and can be related with the aggressivity of tumor and the appearance of the second tumors.

Manual de Adiestramiento sobre Terapia de Rehidratacion Oral y Control de las Enfermedades Diarreicas (Oral Rehydration Therapy and the Control of Diarrheal Diseases). Training for Development. Peace Corps Information Collection & Exchange Training Manual No. T-53.

ERIC Educational Resources Information Center

Clark, Mari; And Others

This Spanish-language manual was developed to train Peace Corps volunteers and other community health workers in Spanish-speaking countries in oral rehydration therapy (ORT) and the control of diarrheal diseases. Using a competency-based format, the manual contains three training modules (organized in seven sessions) that focus on interrelated…

Construction and validation of a tool to Assess the Use of Light Technologies at Intensive Care Units.

PubMed

Marinho, Pabliane Matias Lordelo; Campos, Maria Pontes de Aguiar; Rodrigues, Eliana Ofélia Llapa; Gois, Cristiane Franca Lisboa; Barreto, Ikaro Daniel de Carvalho

2016-12-19

to construct and validate a tool to assess the use of light technologies by the nursing team at Intensive Care Units. methodological study in which the tool was elaborated by means of the psychometric method for construction based on the categorization of health technologies by Merhy and Franco, from the National Humanization Policy, using the Nursing Intervention Classification taxonomy to categorize the domains of the tool. Agreement Percentages and Content Validity Indices were used for the purpose of validation. The result of the application of the Interrater Agreement Percentage exceeded the recommended level of 80%, highlighting the relevance for the proposed theme in the assessment, with an agreement rate of 99%. the tool was validated with four domains (Bond, Autonomy, Welcoming and Management) and nineteen items that assess the use of light technologies at Intensive Care Units. construir e validar um instrumento para avaliação do uso de tecnologias leves, pela equipe de enfermagem, em Unidades de Terapia Intensiva. estudo metodológico no qual o instrumento foi elaborado utilizando o método psicométrico para construção com base na categorização das tecnologias em saúde de Merhy e Franco, da Política Nacional de Humanização, utilizando-se a taxonomia Nursing Intervention Classification para categorizar os domínios do instrumento. Utilizou-se o Percentual de Concordância e o Índice de Validade de Conteúdo (IVC) para validação. o resultado da aplicação do Percentual de Concordância entre os juízes foi superior ao recomendado de 80%, havendo destaque na avaliação da pertinência ao tema proposto, apresentando um percentual de concordância de 99%. o instrumento foi validado com quatro domínios (Vínculo, Autonomia, Acolhimento e Gestão) e dezenove itens que avaliam o uso das tecnologias leves em Unidade de Terapia Intensiva. construir y validar un instrumento para evaluación del uso de tecnologías leves, por el equipo de enfermería, en Unidades de Terapia Intensiva. estudio metodológico en el cual el instrumento fue elaborado utilizando el método psicométrico para construcción con base en la categorización de las tecnologías en salud de Merhy y Franco, de la Política Nacional de Humanización, la que utilizó la taxonomía Nursing Intervention Classification para categorizar los dominios del instrumento. Para la validación se utilizó el Porcentaje de Concordancia y el Índice de Validez de Contenido (IVC). el resultado de la aplicación del Porcentaje de Concordancia entre los jueces fue superior al recomendado de 80%, destacándose la evaluación de la pertinencia al tema propuesto, presentando un porcentaje de concordancia de 99%. el instrumento fue validado en cuatro dominios (Vínculo, Autonomía, Acogimiento y Administración) y con diecinueve ítems que evalúan el uso de las tecnologías leves en Unidad de Terapia Intensiva.

Use of black vulture (Coragyps atratus) in complementary and alternative therapies for cancer in Colombia: A qualitative study

PubMed Central

2012-01-01

Background Although Coragyps atratus has been used as a traditional therapy for patients with cancer, the scientific literature does not contain enough information on how this therapy is used or the mechanisms that explain this therapeutic practice. Objectives To understand the methods of use and the reasons given by patients and caregivers for the use of Coragyps atratus in cancer treatment. Methods This study used a qualitative design based on twenty in-depth interviews of patients with cancer or caregivers of patients with the disease. The analysis of the text was based on an inductive thematic approach. Results Resistance to disease and immune enhancement are properties attributed to Coragyps atratus when used for cancer treatment. The most recommended method of use is fresh blood ingestion, and the associated mechanism of action is transfer of immune factors to the individual who consumes it. Conclusions Use of Coragyps atratus as a treatment for cancer is a popular alternative therapy in Colombia. More studies are needed to understand the clinical effects of this intervention in cancer patients. Spanish abstract Introducción Aunque Coragyps atratus se usa tradicionalmente como terapia para pacientes con cáncer, no existe suficiente información en la literatura científica sobre su forma de utilización ni sobre los mecanismos explicativos que subyacen a esta práctica terapéutica. Objetivos Conocer métodos de utilización y mecanismos explicativos dados por los pacientes y cuidadores de pacientes sobre el uso de Coragyps atratus en el tratamiento del cáncer. Materiales y métodos Diseño cualitativo basado en veinte entrevistas en profundidad de pacientes con cáncer o cuidadores de pacientes con esta enfermedad. Análisis de texto basado en enfoque temático inductivo. Resultados Al Coragyps atratus se le atribuyen propiedades de resistencia y fortalecimiento del sistema inmune de personas enfermas de cáncer. La forma de utilización mas común es la ingesta de la sangre fresca y el mecanismo de acción asociado es la transferencia de defensas a quien lo consume. Conclusiones La utilización del Coragyps atratus como tratamiento para el cáncer es una terapia alternativa usada popularmente en Colombia. El uso de este animal debe estudiarse más a fondo para conocer los efectos clínicos en los pacientes con cáncer. PMID:22651097

Morale as a Protection Factor against Mission Related Stress

DTIC Science & Technology

2006-04-01

la Gándara, J. J.(1998). El Bournout en el Ejército. En De la Gándara (Ed.), Estrés y ... la Gándara (Ed.), Estrés y Trabajo. El síndrome del burnout (pp.15-88). Madrid: Cauce Editorial. [22] Peiró, J.M. (1993): Desencadenantes del...para la mejora de las Condiciones de Vida y de Trabajo. [25] Brengelmann, J. C. (1987). Estrés y Terapia contra el Estrés: Un Proyecto

TECNOLOGÍAS DE INFORMACIÓN Y COMUNICACIÓN PARA LA PREVENCIÓN Y CONTROL DE LA INFECCIÓN POR EL VIH Y OTRAS ITS*

PubMed Central

Curioso, Walter H.; Blas, Magaly M.; Kurth, Ann E.; Klausner, Jeffrey D.

2010-01-01

Avances tecnológicos innovadores como Internet, computadoras personales de bolsillo, teléfonos celulares y otros equipos son un arsenal en crecimiento en el esfuerzo de impedir y controlar el VIH y otras infecciones de transmisión sexual (ITS). A pesar que existe una diversidad de tecnologías de información y comunicación en diferentes etapas de desarrollo para la prevención del VIH e ITS, la investigación en esta área se encuentra aún en crecimiento, y el impacto en la incidencia de enfermedad, las evaluaciones con diseños rigurosos y los estudios económicos todavía son muy limitados. Sin embargo, algunas de estas evidencias son prometedoras y poseen un gran potencial para su uso en nuestro medio. En este artículo hemos realizado una revisión sistemática de la literatura relacionada con el uso de la tecnología aplicada a la prevención y control del VIH e ITS. De ser usada apropiadamente, esta tecnología podría mejorar la vigilancia del VIH y otras ITS, diagnóstico, notificación de parejas, prevención, manejo clínico, y capacitación de profesionales de la salud. PMID:26339254

Longitudinal hemodynamics in acute phase of treatment with labetalol in hypertensive pregnant women to predict need for vasodilatory therapy.

PubMed

Stott, D; Bolten, M; Paraschiv, D; Papastefanou, I; Chambers, J B; Kametas, N A

2017-01-01

Hypertensive pregnant women who do not respond to treatment with labetalol to control blood pressure (BP), but require vasodilatory therapy, progress rapidly to severe hypertension. This could be delayed by early recognition and individualized treatment. In this study, we sought to create prediction models from data at presentation and at 1 h and 24 h after commencement of treatment to identify patients who will not have a sustained response to labetalol and therefore need vasodilatory therapy. The study population comprised 134 women presenting with hypertension at a UK hospital. Treatment with oral labetalol was administered when BP was > 150/100 mmHg or > 140/90 mmHg with systemic disease. BP and hemodynamic parameters were recorded at presentation and at 1 h and 24 h after commencement of treatment. Labetalol doses were titrated to maintain BP around 135/85 mmHg. Women with unresponsive BP, despite labetalol dose maximization (2400 mg/day), received additional vasodilatory therapy with nifedipine. Binary logistic and longitudinal (mixed-model) data analyses were performed to create prediction models anticipating the likelihood of hypertensive women needing vasodilatory therapy. The prediction models were created from data at presentation and at 1 h and 24 h after treatment, to assess the value of central hemodynamics relative to the predictive power of BP, heart rate and demographic variables at these intervals. Twenty-two percent of our cohort required additional vasodilatory therapy antenatally. These women had higher rates of severe hypertension and delivered smaller babies at earlier gestational ages. The unresponsive women were more likely to be of black ethnicity, had higher BP and peripheral vascular resistance (PVR), and lower heart rate and cardiac output (CO) at presentation. Those who needed vasodilatory therapy showed an initial decrease in BP and PVR, which rebounded at 24 h, whereas BP and PVR in those who responded to labetalol showed a sustained decrease at 1 h and 24 h. Stroke volume and CO did not decrease during the acute phase of treatment in either group. The best model for prediction of the need for vasodilators was provided at 24 h by combining ethnicity and longitudinal BP and heart rate changes. The model achieved a detection rate of 100% for a false-positive rate of 20% and an area under the receiver-operating characteristics curve of 0.97. Maternal demographics and hemodynamic changes in the acute phase of labetalol monotherapy provide a powerful tool to identify hypertensive pregnant patients who are unlikely to have their BP controlled by this therapy and will consequently need additional vasodilatory therapy. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd. Las embarazadas hipertensas que no responden al tratamiento con labetalol para el control de la presión arterial (PA), pero que requieren terapia vasodilatadora, evolucionan rápidamente hacia una hipertensión severa. Ésta se puede retrasar mediante un diagnóstico precoz y un tratamiento individual. En este estudio se ha tratado de crear modelos de predicción a partir de datos al inicio del tratamiento y al cabo de 1 hora y de 24 horas después del mismo, para identificar a las pacientes que no mostrarán una respuesta constante al labetalol y que por lo tanto necesitarán terapia vasodilatadora. MÉTODOS: La población de estudio incluyó 134 mujeres con hipertensión en un hospital del Reino Unido. El tratamiento con labetalol por vía oral se administró cuando la PA fue >150/100 mm de Hg o >140/90 mm de Hg con enfermedad multisistémica. Se registró la PA y los parámetros hemodinámicos tanto al inicio como al cabo de 1 h y de 24 h después del inicio del tratamiento. Las dosis de Labetalol se ajustaron para mantener la PA en torno a los 135/85 mm de Hg. Las mujeres cuya PA no produjo respuesta, a pesar de haberles administrado la dosis máxima de labetalol (2400 mg/día), recibieron terapia vasodilatadora adicional con nifedipino. Se realizaron análisis de datos mediante logística binaria y longitudinal (modelo mixto), para crear modelos de predicción con los que pronosticar la probabilidad de la necesidad de terapia vasodilatadora en mujeres hipertensas. Los modelos de predicción se crearon a partir de datos al inicio y al cabo de 1 hora y 24 horas del tratamiento, para evaluar el valor de los parámetros hemodinámicos principales con respecto a la capacidad predictiva de la PA, la frecuencia cardíaca y las variables demográficas en estos intervalos. El 22 % de la cohorte necesitó terapia vasodilatadora adicional antes del parto. Estas mujeres tuvieron tasas más altas de hipertensión grave y neonatos más pequeños en edades gestacionales más tempranas. Las mujeres que no respondieron al tratamiento fueron con más frecuencia de raza negra, tuvieron la PA y la resistencia vascular periférica (RVP) más alta, y la frecuencia cardíaca y el gasto cardíaco (GC) más bajos al inicio del tratamiento. Aquellas que necesitaron terapia vasodilatadora mostraron un descenso inicial de la PA y la RVP, que se recuperó al cabo de 24 h, mientras que la PA y la RVP en las que respondieron al labetalol mostraron una disminución constante al cabo de 1 h y de 24 h. El volumen sistólico y el GC no disminuyeron durante la fase aguda del tratamiento en ninguno de los grupos. El mejor modelo para la predicción de la necesidad de vasodilatadores se obtuvo a las 24 h mediante la combinación de la etnia con los cambios longitudinales de la PA y la frecuencia cardíaca. El modelo alcanzó una tasa de detección del 100% para una tasa de falsos positivos del 20% y un área bajo la curva de características operativas del receptor de 0,97. CONCLUSIÓN: Los datos demográficos maternos y los cambios hemodinámicos en la fase aguda de la monoterapia con labetalol constituyen una herramienta poderosa para identificar a las pacientes embarazadas hipertensas con pocas probabilidades de que se les pueda controlar su PA mediante esta terapia y que por lo tanto necesitarán terapia vasodilatadora adicional. : 、(blood pressure,BP),。。,1 h24 h,。 : 134。BP>150/100 mmHgBP>140/90 mmHg。1 h24 hBP。,BP135/85 mmHg。BP,()。logistic(),。1 h24 h,,BP、。 : 22%。。,BP(peripheral vascular resistance,PVR),(cardiac output,CO)。BPPVR,24 h,1 h24 hBPPVR。CO。24hBP。100%,20%,0.97。 : ,BP。. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.

Potential drug interactions in patients given antiretroviral therapy.

PubMed

Santos, Wendel Mombaque Dos; Secoli, Silvia Regina; Padoin, Stela Maris de Mello

2016-11-21

to investigate potential drug-drug interactions (PDDI) in patients with HIV infection on antiretroviral therapy. a cross-sectional study was conducted on 161 adults with HIV infection. Clinical, socio demographic, and antiretroviral treatment data were collected. To analyze the potential drug interactions, we used the software Micromedex(r). Statistical analysis was performed by binary logistic regression, with a p-value of ≤0.05 considered statistically significant. of the participants, 52.2% were exposed to potential drug-drug interactions. In total, there were 218 potential drug-drug interactions, of which 79.8% occurred between drugs used for antiretroviral therapy. There was an association between the use of five or more medications and potential drug-drug interactions (p = 0.000) and between the time period of antiretroviral therapy being over six years and potential drug-drug interactions (p < 0.00). The clinical impact was prevalent sedation and cardiotoxicity. the PDDI identified in this study of moderate and higher severity are events that not only affect the therapeutic response leading to toxicity in the central nervous and cardiovascular systems, but also can interfere in tests used for detection of HIV resistance to antiretroviral drugs. investigar potenciais interações droga-droga (PDDI) em pacientes infectados com HIV em terapia de antirretroviral. um estudo de corte transversal foi conduzido em 161 pessoas infectadas com o HIV. Dados de tratamentos clínicos, sociodemográficos e antirretrovirais foram coletados. Para analisar a possível interação medicamentosa, nós usamos o software Micromedex(r). A análise estatística foi feita por regressão logística binária, com um valor P de ≤0.05, considerado estatisticamente significativo. dos participantes, 52.2% foram expostos a potenciais interações droga-droga. No total, houve 218 interações droga-droga, das quais 79.8% ocorreram entre drogas usadas para a terapia antirretroviral. Houve uma associação entre o uso de cinco ou mais medicamentos e possíveis interações droga-droga (p = 0.000), e entre o período de tempo de terapia antirretroviral acima de seis anos e possíveis interações droga-droga (p < 0.00). O impacto clínico foi sedação prevalente e cardiotoxicidade. as PDDI identificadas neste estudo de severidade moderada e superior são eventos que não somente afetam o resultado terapêutico levando a toxicidade nos sistema nervoso central e cardiovascular, mas também podem interferir em testes utilizados para a detecção da resistência do HIV aos medicamentos antirretrovirais. investigar las posibles interacciones fármaco-fármaco (PDDI en inglés) en pacientes con infección por VIH que reciben terapia antirretroviral. un estudio transversal se llevó a cabo en 161 adultos con infección por VIH. Se recogieron datos clínicos, socio demográficos, y de tratamiento antirretroviral. Para analizar las posibles interacciones entre medicamentos, se utilizó el software Micromedex(r). El análisis estadístico se realizó mediante regresión logística binaria, considerando estadísticamente significativo un valor de p de ≤0.05. de todos los participantes, el 52,2% fueron expuestos a posibles interacciones entre fármacos. En total, aparecieron 218 interacciones entre fármacos potenciales, de las que el 79,8% se produjo entre los fármacos utilizados para el tratamiento antirretroviral. Se observó una asociación entre el uso de cinco o más medicamentos y posibles interacciones fármaco-fármaco (p = 0,000) y entre el período de tiempo de la terapia antirretroviral de más de seis años y las posibles interacciones fármaco-fármaco (p <0.00). El impacto clínico fue la sedación prevalente y cardiotoxicidad. las PDDI identificadas en este estudio de gravedad moderada y superior son eventos que no sólo afectan a la respuesta terapéutica con riesgo de toxicidad en el sistema nervioso central y cardiovascular, pero también pueden interferir en las pruebas utilizadas para la detección de la resistencia del VIH a los antirretrovirales.

Diagnostics and Therapy with Radioisotopes; DIAGNOSTICA E TERAPIA CON I RADIOISOTOPI

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bastai, P.; Antogenetti, I.; Dogliotti, G.C.

1962-01-01

A review of the principal studies done on diagnosis and therapy with radioisotopes is presented. The book is divided into four sections. The ftrst section deals with the theoretical and practical fundamentals for an understanding of the use of radiosiotopes in diagnosis and treatment. The basic ideas of radioisotopic measurement are reviewed in the second section. The third section presents the applications of radioisotopes to clinical diagnosis, and the fourth section their application to clinical therapy. Abstracts have been prepared of the 35 papers compiled. (J.S.R.)

[Combination drug therapy in leprosy].

PubMed

Terencio de las Aguas, J

1983-01-01

The importance of polichemotherapy in multibacilar leprosy (LL and LD) in patients without any previous therapy as in those diagnosticated and under monotherapy most of all in the resistance patients is presented. Sulphones, clofazimine and rifampicine are selected as first rate drugs and protionamide-etionamide as second rate drugs. The therapy plans with the association of two and three drugs and the convenience of continuing indefinitely with at least one of the drugs are presented insisting on the advantages of the clofazimine-sulphones and rifampicine-sulphones associations. The necessity of immunotherapy for recover of celular immunity against the bacilus, is the only form of preventing relapses and drug resistance.

Evidence-based measures to prevent central line-associated bloodstream infections: a systematic review.

PubMed

Perin, Daniele Cristina; Erdmann, Alacoque Lorenzini; Higashi, Giovana Dorneles Callegaro; Sasso, Grace Teresinha Marcon Dal

2016-09-01

to identify evidence-based care to prevent CLABSI among adult patients hospitalized in ICUs. systematic review conducted in the following databases: PubMed, Scopus, Cinahl, Web of Science, Lilacs, Bdenf and Cochrane Studies addressing care and maintenance of central venous catheters, published from January 2011 to July 2014 were searched. The 34 studies identified were organized in an instrument and assessed by using the classification provided by the Joanna Briggs Institute. the studies presented care bundles including elements such as hand hygiene and maximal barrier precautions; multidimensional programs and strategies such as impregnated catheters and bandages and the involvement of facilities in and commitment of staff to preventing infections. care bundles coupled with education and the commitment of both staff and institutions is a strategy that can contribute to decreased rates of central line-associated bloodstream infections among adult patients hospitalized in intensive care units. identificar evidências de cuidados para prevenção de infecção de corrente sanguínea relacionada a cateter venoso central em pacientes adultos em Unidades de Terapia Intensiva. revisão Sistemática realizada por meio de busca nas bases de dados Pubmed, Scopus, Cinahl, Web of Science, Lilacs, Bdenf e Cochrane. Foram buscadas pesquisas com cuidados com a cateterização e manutenção do cateter venoso central, publicados de janeiro de 2011 a julho de 2014. Os 34 estudos incluídos foram organizados em um instrumento e avaliados por meio da classificação do The Joanna Briggs Institute. os estudos apresentaram bundles de cuidados com elementos como a higiene das mãos e precauções máximas de barreira; programas multidimensionais e estratégias como cateteres e curativos impregnados e o envolvimento da instituição e engajamento da equipe nos esforços para prevenção de infecção. os cuidados no formato de bundles aliados com a educação e engajamento da equipe e da instituição são estratégias que poderão contribuir para a redução das taxas de infecção de corrente sanguínea relacionada a cateter venoso central em pacientes adultos em unidades de terapia intensiva. identificar evidencias de cuidados para prevención de infección de la corriente sanguínea relacionada al catéter venoso central, en pacientes adultos en Unidades de Terapia Intensiva. revisión sistemática realizada por medio de búsqueda en las bases de datos Pubmed, Scopus, Cinahl, Web of Science, Lilacs, Bdenf y Cochrane. Fueron buscadas investigaciones de cuidados con la cateterización y manutención del catéter venoso central, publicados de enero de 2011 a julio de 2014. Los 34 estudios incluidos fueron organizados en un instrumento y evaluados por medio de la clasificación del The Joanna Briggs Institute. los estudios presentaron bundles de cuidados con elementos como: higiene de las manos y precauciones máximas de barrera; programas multidimensionales y estrategias como catéteres y curativos impregnados y, participación de la institución y compromiso del equipo en los esfuerzos para prevención de la infección. los cuidados en el formato de bundles aliados con la educación y compromiso del equipo y de la institución, son estrategias que podrán contribuir para la reducción de las tasas de infección de la corriente sanguínea relacionadas al catéter venoso central, en pacientes adultos en unidades de terapia intensiva.

"Fuzziness" in the celular interactome: a historical perspective.

PubMed

Welch, G Rickey

2012-01-01

Some historical background is given for appreciating the impact of the empirical construct known as the cellular protein-protein interactome, which is a seemingly de novo entity that has arisen of late within the context of postgenomic systems biology. The approach here builds on a generalized principle of "fuzziness" in protein behavior, proposed by Tompa and Fuxreiter.(1) Recent controversies in the analysis and interpretation of the interactome studies are rationalized historically under the auspices of this concept. There is an extensive literature on protein-protein interactions, dating to the mid-1900s, which may help clarify the "fuzziness" in the interactome picture and, also, provide a basis for understanding the physiological importance of protein-protein interactions in vivo.

A bone tissue engineering strategy based on starch scaffolds and bone marrow cells cultured in a flow perfusion bioreactor

NASA Astrophysics Data System (ADS)

Gomes, Maria Manuela Estima

A Engenharia de Tecidos e uma area cientifica em continua expansao. Os desenvolvimentos conseguidos por esta area tem contribuido significativamente para diversos avancos no campo da Medicina Regenerativa. Esta ciencia interdisciplinar combina os conhecimentos de diversas outras areas, tao distintas como a Engenharia de Materiais e a Biologia, com o objectivo de desenvolver substitutos sinteticos para tecidos humanos. Para se atingir este objectivo utilizam-se, de uma forma generica, combinacoes especificas de celulas e de um material de suporte tridimensional com propriedades adequadas, gerando um material hibrido cujas caracteristicas podem ainda ser moduladas atraves do sistema de cultura usado. A presente tese e centrada no desenvolvimento de estrategias de engenharia de tecido osseo baseadas na cultura in vitro de celulas previamente "semeadas" num suporte tridimensional ("scaffold"). Esta estrategia permite que as celulas adiram ao suporte, proliferem e segreguem matriz extracelular especifica do tecido osseo, ate se obter um substituto artificial funcional com caracteristicas do tecido original, que pode finalmente ser transplantado para tratar o defeito em causa. Para que uma estrategia deste tipo seja bem sucedida, pelo menos tres componentes fundamentais devem ser cuidadosamente estudados: o material de suporte (scaffold), as celulas a usar e o sistema de cultura in vitro. Dai que os principais objectivos desta tese estejam relacionados com estes tres aspectos, nomeadamente: • Desenvolvimento de scaffolds biodegradaveis a partir de polimeros a base de amido de milho que induzam a adesao e proliferacao celular e que apresentem propriedades adequadas, tais como a porosidade e interconectividade entre poros, de forma a proporcionar um ambiente que favoreca o desenvolvimento in vitro de um material hibrido com caracteristicas similares ao osso humano. • Estudo da utilizacao de celulas da medula ossea como uma potencial fonte de celulas para engenharia do tecido osseo, uma vez que estas celulas podem ser facilmente recolhidas do proprio paciente a tratar por metodos nao-invasivos (bioppsia) e em quantidades suficientes. Alem disso, tratando-se de uma fonte de celulas autologas (obtidas do proprio paciente) permitem evitar os riscos de transmissao de doencas contagiosas e/ou de rejeicao pelo sistema imunologico. • Estudo da influencia das condicoes de cultura in vitro geradas por um bioreactor de perfusao (em comparacao com os metodos tradicionais de cultura em condicoes estaticas) no desenvolvimento dos materiais hibridos, compostos pelas celulas e scaffolds, assim como as interaccoes do ambiente proporcionado por este sistema de cultura com as diferentes estruturas/arquitecturas e porosidades dos scaffolds utilizados. Estes objectivos convergem para o objectivo geral desta tese que consistiu no desenvolvimento de uma terapia de engenharia do tecido osseo alternativa as existentes e com potencial para vir a ser posteriormente utilizada na pratica clinica. Este objectivo foi avaliado atraves do estudo da funcionalidade dos materiais hibridos obtidos em diferentes condicoes de cultura in vitro (e utilizando diferentes scaffolds), partindo do principio que o sistema de perfusao poderia eventualmente superar as limitacoes de difusao tipicas dos sistema de cultura estatica e simultaneamente proporcionar estimulos mecânicos as celulas, semelhantes aos encontrados em condicoes fisiologicas. (Abstract shortened by ProQuest.).

[Surface aspect of fixed restaurations and parodontal influences].

PubMed

Ciocan-Pendefunda, Alice-Arina; Forna, Norina Consuela

2012-01-01

Any new class of materials requires a new cutting technology which, unless complied with properly, may negatively impact on the advantages and performance of the material. The modifications appeared as a result of the technological processes in the structure or surface aspect of the materials not only affects the mechanical resistance of the restorations but also casts doubts on their biological qualities. This study evaluates the impact of biomaterials involved in fixed restorations on the periodontal architecture, bearing extremely important connotations in the long run. The "in vitro" testing was conducted on culture cells for the cytotoxic effect of certain restorative materials--metallic alloys used in prosthetic restorations, composite materials, in collaboration with the Virology Laboratory of the Public Health Institute.The tested materials were metallic alloys, composite materials and acrylic resins used for the construction of standard sized plates (out of each material) in order to avoid the differences that might arise from the technological process. Artificial saliva processed to reach a pH = 7 was prepared in the Biophysics Laboratory of UMF Iasi. Material samples and the saliva inoculated with these were tested. -p. The cytotoxic effect of the tested materials on the celular cultures takes on extremely diverse forms, from discrete morphological modifications of the cells with regard to the size, shape, internal structure (for the noble and semi-noble alloys) up to the partial stripping-off of the celular film, the modification of density and coloration. In the case of the witness of non-inoculated culture, the testing results showed the presence of a continuous film, with cells having the same size, transparency and colouring, with an unaltered polyhedral contour, with visible nuclei, an image also kept in the case of the saliva witness. The involvement of restaurative materials in triggering, maintaining and aggravating a periodontal pathology indicates the capital role played by the dentist in the identications of lesions during measures by avoiding or excluding etiological agents before an obvious lesions occurs in the process of active dispensarization.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cirrone, G. A. P.; Cuttone, G.; Di Rosa, F.

After six years of activity 155 patients have been treated inside the CATANA (Centro di AdroTerapia ed Applicazioni Nucleari Avanzate) facility. CATANA is the first and unique proton therapy facility in which the 62 MeV proton beams, accelerated by a Superconducting Cyclotron, are used for the radio-therapeutic treatments of choroidal and iris melanomas. Inside CATANA new absolute and relative dosimetric techniques have been developed in order to achieve the best results in terms of treatment precision and dose release accuracy. The follow-up results for 42 patients demonstrated the efficacy of high energy protons in the radiotherapeutic field and encouraged usmore » in our activity in the battle against cancer.« less

Dosimetric and clinical experience in eye proton treatment at INFN-LNS

NASA Astrophysics Data System (ADS)

Cirrone, G. A. P.; Cuttone, G.; Di Rosa, F.; Lojacono, P.; Mongelli, V.; Lo Nigro, S.; Ott, J.; Patti, I. V.; Pittera, S.; Privitera, G.; Raffaele, L.; Reibaldi, A.; Russo, G.; Salamone, V.; Sabini, M. G.; Spatola, C.; Valastro, L. M.

2009-05-01

After six years of activity 155 patients have been treated inside the CATANA (Centro di AdroTerapia ed Applicazioni Nucleari Avanzate) facility. CATANA is the first and unique proton therapy facility in which the 62 MeV proton beams, accelerated by a Superconducting Cyclotron, are used for the radio-therapeutic treatments of choroidal and iris melanomas. Inside CATANA new absolute and relative dosimetric techniques have been developed in order to achieve the best results in terms of treatment precision and dose release accuracy. The follow-up results for 42 patients demonstrated the efficacy of high energy protons in the radiotherapeutic field and encouraged us in our activity in the battle against cancer

Gastric epithelioid haemangioendothelioma.

PubMed

Tavares, A B; Almeida, A G; Viveiros, F A; Cidade, C N; Barbosa, J M

2011-05-10

Epithelioid haemangioendothelioma (EHE) is a rare tumour of vascular origin, characterised by celular proliferation, endotelial, epitelioid or hystiocitoid. It may develop in any organ, but it is more common in lung and liver. Surgery is the recommended treatment; however, in case of a potentially benign situation, an expectant attitude should be adopted. The case reports a 71-year-old female who underwent a laparotomy for a colonic adenocarcinoma. During surgery, a polypoid lesion in the dependency of the gastric wall was found incidentally, which was removed. Histopathology and immunohistochemical analysis confirmed the diagnosis of EHE. Gastric vascular neoplasms represent about 0.9-3.3% of all gastric tumours. Usually have a good prognosis, but due to the borderline biological behaviour of these tumours, it is important to have a detailed clinical evaluation at follow-up of these patients.

[Photodrugtherapy of psoriasis with oral psoralen and black light therapy].

PubMed

Corrales Padilla, H

1975-01-01

Oral 4, 5', 8 trimethoxypsoralen (TMP) or 8-M-methoxypsoralen (8 MP) plus black light therapy of psoriasis produced disappearing of lesions in 6 out of 8 pacients treated with TMP and in 6 out of 7 treated with 8 MP. In three patients treated with the first drug, a paired comparision demonstrated that the ingestion of it, when followed of black exposure, is more effective than the exposure to conventional ultraviolet light. Parrish et al. have shown this for oral methoxalen and long wave ultraviolet light. Combined TMP or 8-MP and black light therapy inhibits epidermal DNA synthesis and this is the scientific base of its application in the therapy of psoriasis, disease in which an accelerated celular cicle and DNA synthesis has been postulated.

Slips, lapses and mistakes inthe use of equipment by nurses in an intensive care unit.

PubMed

Ribeiro, Gabriella da Silva Rangel; Silva, Rafael Celestino da; Ferreira, Márcia de Assunção; Silva, Grazielle Rezende da

2016-01-01

Toidentify the occurrence of errors in the use of equipment by nurses working in intensive careandanalyzing them in the framework of James Reason's theory of human error. Qualitative field study in the intensive care unit of a federal hospital in the city of Rio de Janeiro. Observation and interviews were conductedwith eight nurses, from March to December 2014. Content analysis was used for the interviews, as well as the description of the scenes observed. Lapses of memory and attention were identified in the handling of infusion pumps, as well as planning failures during the programming of monitors. Errors cause adverse events that compromise patient safety. The authors propose creation of an instrument for daily checking of equipment, with checks throughout the work process in the programming of infusion pumps and monitors, in order to reduce failures and memory lapses. Identificar a ocorrência de erros na utilização de equipamentos por enfermeiros que atuam na terapia intensiva, analisando-os à luz da teoria do erro humano de James Reason. Pesquisa de campo, qualitativa, na Unidade de Terapia Intensiva de um hospital federal do Rio de Janeiro. Realizou-se observação e entrevista com oito enfermeiros, de março a dezembro de 2014. Aplicou-se análise de conteúdo nas entrevistas e descrição densa nas cenas observadas. Identificaram-se falhas de memória e de atenção no manuseio das bombas infusoras e falhas de planejamento durante a programação dos monitores. Os erros causam eventos adversos que comprometem a segurança do paciente. Propõe-se um instrumento de verificação diária dos equipamentos, com checagens ao longo do processo de trabalho da programação das bombas infusoras e monitores, no intuito de reduzir as falhas e esquecimentos.

[Cutaneo-viscero-hemolytic loxoscelism with acute renal failure].

PubMed

Alfaro, Flavia V; Dotto, Beatriz; Sesin, Ana M; Prettini, Viviana; Sesin, Jorge; Aliciardi, Enrique; Vergottini, Juan C; Gonzalez, Mauricio

2008-01-01

The Loxoscelism is caused by the bite of spider Loxosceles laeta gender, of worldwide distribution. The poisoning can cause lesions dermonecrotic and less frequently a systemic illness that can be fatal. The mechanism of venom action is multifactorial. The characteristic dermonecrotic lesion results from the direct effects of the venom on the celular and basal membrane components, as well as the extracelular matrix. The initial interaction between the poison and tissues, causes complement activation, migration of polymorphic neutrophils, liberation of proteolytic enzymes, cytoquines, aggregation platelet, and blood flow alterations that result in edema and ischemia, with development of necrosis. There is no a definitive treatment for loxoscelism. However, the value of specific antivenom, to decrease lesion size and limit systemic illness even when such administration is delayed. We present a case of cutaneous-visceral loxoscelismo with unfavorable evolution.

Professional nursing practice in critical units: assessment of work environment characteristics.

PubMed

Maurício, Luiz Felipe Sales; Okuno, Meiry Fernanda Pinto; Campanharo, Cássia Regina Vancini; Lopes, Maria Carolina Barbosa Teixeira; Belasco, Angélica Gonçalves Silva; Batista, Ruth Ester Assayag

2017-03-02

assess the autonomy, control over environment, and organizational support of nurses' work process and the relationships between physicians and nurses in critical care units. cross-sectional study conducted with 162 nurses working in the intensive care units and emergency service of a university hospital. The workers' satisfaction with their work environment was assessed using Brazilian Nursing Work Index - Revised, translated and adapted for the Brazilian culture. average age was 31.6 ± 3.9 years; 80.2% were women; 68.5% Caucasians and 71.6% worked in intensive care units. The nurses considered autonomy (2.38 ± 0.64) and their relationship with physicians (2.24 ± 0.62) to be characteristics of the work environment that favored professional practice. Control over environment (2.78 ± 0.62) and organizational support (2.51 ± 0.54), however, were considered to be unfavorable. No statistically significant differences were found between the units based on the scores obtained by the professionals on the Brazilian Nursing Work Index - Revised. autonomy, relationship between physicians and nurses, and organizational support were considered by the units to be characteristics that favored nurses' professional practices. On the other hand, control over environment and organizational support were considered unfavorable. evaluar la autonomía, el control sobre el ambiente, el soporte organizacional del proceso de trabajo de los enfermeros y las relaciones entre médicos y enfermeros, en unidades críticas. estudio transversal realizado en 162 enfermeros de las unidades de terapia intensiva y del servicio de emergencia de un hospital universitario. La evaluación de la satisfacción del profesional con el ambiente de trabajo fue realizada utilizando el Brazilian Nursing Work Index - Revised, traducido y adaptado para la cultura brasileña. el promedio de edad fue 31,6 ± 3,9 años, 80,2% eran mujeres, 68,5% blancos y 71,6% trabajaban en la unidad de terapia intensiva. Los enfermeros consideraron que la autonomía (2,38 ± 0,64) y la relación médico y enfermero (2,24 ± 0,62) fueron las características del ambiente de trabajo favorables a la práctica profesional. Entretanto, consideraron como desfavorables el control del ambiente (2,78 ± 0,62) y el soporte organizacional (2,51 ± 0,54). No hubo diferencia estadísticamente significativa en el Brazilian Nursing Work Index - Revised entre la evaluación de los profesionales de las unidades evaluadas. en las unidades evaluadas, la autonomía, la relación médico y enfermero y el soporte organizacional fueron las características que favorecieron la práctica profesional del enfermero. En contrapartida, el control del ambiente y el soporte organizacional fueron relatados como desfavorables. avaliar a autonomia, o controle sobre o ambiente, o suporte organizacional do processo de trabalho dos enfermeiros e as relações entre médicos e enfermeiros em unidades críticas. estudo transversal realizado com 162 enfermeiros das unidades de terapia intensiva e do serviço de emergência de um hospital universitário. A avaliação da satisfação do profissional com o ambiente de trabalho foi realizada por meio do Brazilian Nursing Work Index - Revised, traduzido e adaptado para a cultura brasileira. a média de idade foi 31,6 ± 3,9 anos, 80,2% mulheres, 68,5% brancos e 71,6% trabalhavam em unidade de terapia intensiva. Os enfermeiros consideraram que autonomia (2,38 ± 0,64) e relação médico e enfermeiro (2,24 ± 0,62) foram características do ambiente de trabalho favoráveis à prática profissional. Entretanto, consideraram como desfavoráveis o controle do ambiente (2,78 ± 0,62) e o suporte organizacional (2,51 ± 0,54). Não houve diferença estatisticamente significativa no Brazilian Nursing Work Index - Revised entre a avaliação dos profissionais das Unidades avaliadas. nas unidades avaliadas, a autonomia, relação médico e enfermeiro e o suporte organizacional foram características que favoreceram a prática profissional do enfermeiro. Em contrapartida, o controle do ambiente e o suporte organizacional foram relatados como desfavoráveis.

Infusion pumps and red blood cell damage in transfusion therapy: an integrative revision of the academic literature.

PubMed

Wilson, Ana Maria Miranda Martins; Peterlini, Maria Angélica Sorgini; Pedreira, Mavilde da Luz Gonçalves

2016-08-15

to obtain information from scientific literature concerning infusion pumps used in administering erythrocyte (red blood cells) and to evaluate the implications in the practical use of this equipment by nurses when conducting transfusions. an integrative revision of the following scientific databases: Pubmed/Medline, Scopus, the Virtual Library for Health, SciELO, Web of Science and Cochrane. The following descriptors were used: "infusion pumps", "blood transfusion", "transfused erythrocyte" and "hemolyis". There were no restrictions on the scope of the initial data and it was finalized in December 2014. 17 articles were identified in accordance with the inclusion and exclusion criteria. all of the publications included in the studies were experimental in vitro and covered the use of infusion pumps in transfusion therapy. A summary of the data was presented in a synoptic chart and an analysis of it generated the following categories: cellular damage and the infusion mechanism. infusion pumps can be harmful to erythrocytes based on the infusion mechanism that is used, as the linear peristaltic pump is more likely to cause hemolysis. Cellular damage is related to the plasmatic liberation of markers that largely dominate free hemoglobin and potassium. We reiterate the need for further research and technological investments to guide the development of protocols that promote safe practices and that can contribute to future clinical studies. identificar na literatura a produção científica acerca dos efeitos de bomba de infusão na administração de hemácias e avaliar as implicações do uso desses equipamentos na prática transfusional de enfermagem. revisão integrativa de literatura nas bases de dados Pubmed/Medline, Scopus, Biblioteca Virtual em Saúde, SciELO, Web of Science e Cochrane, utilizando os descritores "bombas de infusão", "transfusão de sangue", "transfusão de eritrócitos" e "hemólise". A data inicial não foi delimitada e a final foi dezembro de 2014. Foram identificados 17 artigos de acordo com os critérios de inclusão e exclusão. Todas as publicações incluídas eram estudos experimentais in vitro e abordavam o uso de bombas de infusão na terapêutica transfusional. A síntese dos dados foi apresentada em quadro sinóptico e a análise gerou duas categorias relevantes: lesão celular e mecanismo de infusão. bombas de infusão podem ser deletérias às hemácias de acordo o mecanismo de infusão, sendo que as peristálticas lineares foram mais predisponentes à hemólise. A lesão celular foi relacionada à liberação plasmática de marcadores, predominando a hemoglobina livre e potássio. Reitera-se a necessidade de pesquisas adicionais e investimentos tecnológicos para nortear o desenvolvimento de protocolos que promovam prática segura e que subsidiem futuros estudos clínicos. identificar en la literatura la producción científica acerca de los efectos de la bomba de transfusión en la administración de glóbulos rojos y evaluar las implicaciones del uso de esos equipos en la práctica transfusional de enfermería. revisión integradora de literatura en las bases de datos Pubmed/Medline, Scopus, Biblioteca Virtual en Salud, SciELO, Web of Science y Cochrane, utilizando los descriptores "bombas de infusión", "transfusión de sangre", "transfusión de eritrocitos" y "hemolisis". La fecha inicial no fue delimitada y la final fue en diciembre de 2014. Fueron identificados 17 artículos de acuerdo con los criterios de inclusión y exclusión. todas las publicaciones incluidas eran estudios experimentales in vitro y abordaban el uso de bombas de infusión en la terapéutica transfusional. La síntesis de los datos se presenta en un cuadro sinóptico y el análisis generó dos categorías relevantes: lesión celular y mecanismo de transfusión. las bombas de infusión pueden ser perjudiciales para los glóbulos rojos de acuerdo el mecanismo de transfusión, siendo que las peristálticas lineares fueron más predisponentes para la hemolisis. La lesión celular fue relacionada a la liberación plasmática de marcadores, predominando la hemoglobina libre y el potasio. Se reitera la necesidad de realizar investigaciones adicionales e inversiones tecnológicas que puedan orientar el desarrollo de protocolos que promuevan la práctica segura y que ayuden a futuros estudios clínicos.

Effectiveness of psychosocial interventions in eating disorders: an overview of Cochrane systematic reviews.

PubMed

Costa, Marcelle Barrueco; Melnik, Tamara

2016-01-01

Eating disorders are psychiatric conditions originated from and perpetuated by individual, family and sociocultural factors. The psychosocial approach to treatment and prevention of relapse is crucial. To present an overview of the scientific evidence on effectiveness of psychosocial interventions in treatment of eating disorders. All systematic reviews published by the Cochrane Database of Systematic Reviews - Cochrane Library on the topic were included. Afterwards, as from the least recent date of these reviews (2001), an additional search was conducted at PubMed with sensitive search strategy and with the same keywords used. A total of 101 primary studies and 30 systematic reviews (5 Cochrane systematic reviews), meta-analysis, guidelines or narrative reviews of literature were included. The main outcomes were: symptomatic remission, body image, cognitive distortion, psychiatric comorbidity, psychosocial functioning and patient satisfaction. The cognitive behavioral approach was the most effective treatment, especially for bulimia nervosa, binge eating disorder and the night eating syndrome. For anorexia nervosa, the family approach showed greater effectiveness. Other effective approaches were interpersonal psychotherapy, dialectic behavioral therapy, support therapy and self-help manuals. Moreover, there was an increasing number of preventive and promotional approaches that addressed individual, family and social risk factors, being promising for the development of positive self-image and self-efficacy. Further studies are required to evaluate the impact of multidisciplinary approaches on all eating disorders, as well as the cost-effectiveness of some effective modalities, such as the cognitive behavioral therapy. RESUMO Transtornos alimentares são doenças psiquiátricas originadas de e perpetuadas por fatores individuais, familiares e socioculturais. A abordagem psicossocial é essencial para o tratamento e a prevenção de recaídas. Apresentar uma visão geral das evidências científicas sobre a efetividade das intervenções psicossociais no tratamento de transtornos alimentares. Foram incluídas todas as revisões sistemáticas publicadas no Banco de Dados de Revisões Sistemáticas da Cochrane Library. Posteriormente, a partir da data menos recente destas revisões (2001), realizou-se uma busca adicional no PubMed, com estratégia de busca sensibilizada e com os mesmos descritores utilizados antes. No total, foram incluídos 101 estudos primários e 30 revisões sistemáticas (5 revisões sistemáticas da Cochrane), metanálises, diretrizes ou revisões narrativas da literatura. Os principais desfechos foram remissão de sintomas, imagem corporal, distorção cognitiva, comorbidade psiquiátrica, funcionamento psicossocial e satisfação do paciente. A abordagem cognitivo-comportamental foi o tratamento mais efetivo, principalmente para bulimia nervosa, transtorno da compulsão alimentar periódica e síndrome do comer noturno. Para anorexia nervosa, a abordagem familiar demonstrou maior efetividade. Outras abordagens efetivas foram psicoterapia interpessoal, terapia comportamental dialética, terapia de apoio e manuais de autoajuda. Além disso, houve um número crescente de abordagens preventivas e promocionais que contemplaram fatores de risco individuais, familiares e sociais, sendo promissoras para o desenvolvimento da autoimagem positiva e autoeficácia. São necessários mais estudos que avaliem o impacto de abordagens multidisciplinares em todos transtornos alimentares, além da relação custo-efetividade de algumas modalidades efetivas, como a terapia cognitivo-comportamental.

Risk factors for mortality in ventilator-associated tracheobronchitis: a case-control study.

PubMed

Pontes, Leonilda Giani; Menezes, Fernando Gatti de; Gonçalves, Priscila; Toniolo, Alexandra do Rosário; Silva, Claudia Vallone; Kawagoe, Julia Yaeko; Santos, Camila Marques Dos; Castagna, Helena Maria Fernandes; Martino, Marinês Dalla Valle; Corrêa, Luci

2017-01-01

To describe the microbiological characteristics and to assess the risk factors for mortality of ventilator-associated tracheobronchitis in a case-control study of intensive care patients. This case-control study was conducted over a 6-year period in a 40-bed medical-surgical intensive care unit in a tertiary care, private hospital in São Paulo, Brazil. Case patients were identified using the Nosocomial Infection Control Committee database. For the analysis of risk factors, matched control subjects were selected from the same institution at a 1:8.8 ratio, between January 2006 and December 2011. A total of 40 episodes of ventilator-associated tracheobronchitis were evaluated in 40 patients in the intensive care unit, and 354 intensive care patients who did not experience tracheobronchitis were included as the Control Group. During the 6-year study period, a total of 42 organisms were identified (polymicrobial infections were 5%) and 88.2% of all the microorganisms identified were Gram-negative. Using a logistic regression model, we found the following independent risk factors for mortality in ventilator-associated tracheobronchitis patients: Acute Physiology and Chronic Health Evaluation I score (odds ratio 1.18 per unit of score; 95%CI: 1.05-1.38; p=0.01), and duration of mechanical ventilation (odds ratio 1.09 per day of mechanical ventilation; 95%CI: 1.03-1.17; p=0.004). Our study provided insight into the risk factors for mortality and microbiological characteristics of ventilator-associated tracheobronchitis. Descrever as características microbiológicas e avaliar os fatores de risco para mortalidade na traqueobronquite associada à ventilação mecânica em um estudo caso-controle de pacientes de terapia intensiva. Estudo realizado ao longo de 6 anos em uma unidade de terapia intensiva médico-cirúrgica de 40 leitos, em um hospital privado e de nível terciário em São Paulo, Brasil. O Grupo Caso foi identificado usando o banco de dados da Comissão de Controle de Infecção Hospitalar. O Grupo Controle foi pareado na proporção de 1:8,8 entre janeiro de 2006 e dezembro de 2011. Quarenta episódios de traqueobronquites associadas à ventilação foram avaliados em 40 pacientes na unidade de terapia intensiva, e 354 pacientes não apresentaram traqueobronquite Grupo Controle. Foram identificados 42 microrganismos (dos quais 5% foram infecções polimicrobianas), sendo que 88,2% de todos os microrganismos eram bactérias Gram-negativas. Usando um modelo de regressão logística, encontramos os seguintes fatores de risco independentes para mortalidade em pacientes com traqueobronquites associadas à ventilação: pontuação da Acute Physiology and Chronic Health Evaluation I (odds ratio 1,18 por uma unidade de pontuação; IC95%: 1,05-1,38; p=0,01) e duração da ventilação mecânica (odds ratio 1,09 por dia de ventilação mecânica; IC95%: 1,03-1,17; p=0,004). Nosso estudo forneceu informações sobre os fatores de risco para mortalidade e características microbiológicas da traqueobronquite associada à ventilação mecânica.

Presentation of lipid antigens to T cells.

PubMed

Mori, Lucia; De Libero, Gennaro

2008-04-15

T cells specific for lipid antigens participate in regulation of the immune response during infections, tumor immunosurveillance, allergy and autoimmune diseases. T cells recognize lipid antigens as complexes formed with CD1 antigen-presenting molecules, thus resembling recognition of MHC-peptide complexes. The biophysical properties of lipids impose unique mechanisms for their delivery, internalization into antigen-presenting cells, membrane trafficking, processing, and loading of CD1 molecules. Each of these steps is controlled at molecular and celular levels and determines lipid immunogenicity. Lipid antigens may derive from microbes and from the cellular metabolism, thus allowing the immune system to survey a large repertoire of immunogenic molecules. Recognition of lipid antigens facilitates the detection of infectious agents and the initiation of responses involved in immunoregulation and autoimmunity. This review focuses on the presentation mechanisms and specific recognition of self and bacterial lipid antigens and discusses the important open issues.

The effect of the size of the system, aspect ratio and impurities concentration on the dynamic of emergent magnetic monopoles in artificial spin ice systems

NASA Astrophysics Data System (ADS)

León, Alejandro

2013-08-01

In this work we study the dynamical properties of a finite array of nanomagnets in artificial kagome spin ice at room temperature. The dynamic response of the array of nanomagnets is studied by implementing a "frustrated celular autómata" (FCA), based in the charge model and dipolar model. The FCA simulations allow us to study in real-time and deterministic way, the dynamic of the system, with minimal computational resource. The update function is defined according to the coordination number of vertices in the system. Our results show that for a set geometric parameters of the array of nanomagnets, the system exhibits high density of Dirac strings and high density emergent magnetic monopoles. A study of the effect of disorder in the arrangement of nanomagnets is incorporated in this work.

Contributions for classification of platelet rich plasma - proposal of a new classification: MARSPILL.

PubMed

Lana, Jose Fabio Santos Duarte; Purita, Joseph; Paulus, Christian; Huber, Stephany Cares; Rodrigues, Bruno Lima; Rodrigues, Ana Amélia; Santana, Maria Helena; Madureira, João Lopo; Malheiros Luzo, Ângela Cristina; Belangero, William Dias; Annichino-Bizzacchi, Joyce Maria

2017-07-01

Platelet-rich plasma (PRP) has emerged as a significant therapy used in medical conditions with heterogeneous results. There are some important classifications to try to standardize the PRP procedure. The aim of this report is to describe PRP contents studying celular and molecular components, and also propose a new classification for PRP. The main focus is on mononuclear cells, which comprise progenitor cells and monocytes. In addition, there are important variables related to PRP application incorporated in this study, which are the harvest method, activation, red blood cells, number of spins, image guidance, leukocytes number and light activation. The other focus is the discussion about progenitor cells presence on peripherial blood which are interesting due to neovasculogenesis and proliferation. The function of monocytes (in tissue-macrophages) are discussed here and also its plasticity, a potential property for regenerative medicine treatments.

Mobile phones and elderly people: a noisy communication.

PubMed

Stamato, Cláudia; Moraes, Anamaria de

2012-01-01

Knowing the users is capital for building user-friendly digital interfaces. One way to think about the users is considering their familiarity with this technology. This article presents the results of twelve interviews with elderly people residing in the so-called South Zone of Rio de Janeiro (Brazil) who have used mobile phones over at least one year. It is part of the Doctor's Thesis "Mobile phones for elderly people - usability for social integration" ("Celulares para idosos - usabilidade a serviço da integração social"), which is targeted at ascertaining if the current mobile phones are user-friendly for elderly people. Through the technique of Guided Interviews, we found usage time, criteria for choice of phones, reasons for changes, preferences, and manners of use. Preliminarily, we have noticed differences in the behavior of the participating users and performed a qualitative analysis according to groups of age and gender.

Humanization in the Intensive Care: perception of family and healthcare professionals.

PubMed

Luiz, Flavia Feron; Caregnato, Rita Catalina Aquino; Costa, Márcia Rosa da

2017-01-01

Understanding perceptions of family members and healthcare professionals about humanization at the Intensive Care Unit (ICU) to direct it to an educational action. Exploratory descriptive and qualitative study conducted in an ICU level 3 of a public hospital in Porto Alegre, RS, Brazil, with fourteen subjects, eight family members and six healthcare professionals. Data collection carried out through semi-structured interviews and focus group. Content Analysis was used. Emerged categories were: welcoming; communication; ethical and sensible professionalism; unfavorable aspects; perception on humanization; and religiosity/spirituality. Although the subjects have expressed their perceptions about humanization in different ways, both groups pointed out the same needs and priorities to improve humanization in Intensive Care. From the results, we created a reflective manual of humanizing assistance practices for professionals, a board to facilitate communication of these professionals with patients and a guideline book for family members. Compreender as percepções de familiares e profissionais de saúde sobre humanização na Unidade Terapia Intensiva (UTI) para direcionar a uma ação educativa. Estudo exploratório-descritivo qualitativo, realizado em uma UTI nível III de um hospital público de Porto Alegre/RS com 14 sujeitos, sendo oito familiares e seis profissionais de saúde. Coleta de dados realizada por meio de: entrevistas semiestruturadas e grupo focal. Utilizou-se Análise de Conteúdo. As categorias emergidas foram: acolhida; comunicação; profissionalismo ético e sensível; aspectos desfavoráveis; percepção sobre humanização; e religiosidade/espiritualidade. Apesar dos sujeitos expressarem de maneiras distintas suas percepções sobre humanização, os dois grupos comparados elencaram iguais necessidades e prioridades para o aprimoramento da humanização na Terapia Intensiva. A partir dos resultados, criou-se um Manual Reflexivo de práticas assistenciais humanizadoras para os profissionais, um tabuleiro para facilitar a comunicação destes profissionais com os usuários e um guia de orientações aos familiares.

Critical incidents connected to nurses' leadership in Intensive Care Units.

PubMed

Lima, Elaine Cantarella; Bernardes, Andrea; Baldo, Priscila Lapaz; Maziero, Vanessa Gomes; Camelo, Silvia Helena Henriques; Balsanelli, Alexandre Pazetto

2017-01-01

The goal of this study is to analyze nurses' leadership in intensive care units at hospitals in the state of São Paulo, Brazil, in the face of positive and negative critical incidents. Exploratory, descriptive study, conducted with 24 nurses by using the Critical Incident Technique as a methodological benchmark. Results were grouped into 61 critical incidents distributed into categories. Researchers came to the conclusion that leadership-related situations interfere with IC nurses' behaviors. Among these situations they found: difficulty in the communication process; conflicts in the daily exercise of nurses' activities; people management; and the setting of high quality care targets. Researchers identified a mixed leadership model, leading them to the conclusion that nurses' knowledge and practice of contemporary leadership theories/styles are crucial because they facilitate the communication process, focusing on behavioral aspects and beliefs, in addition to valuing flexibility. This positively impacts the organization's results. Analisar a liderança do enfermeiro em Centros de Terapia Intensiva de hospitais localizados no interior do estado de São Paulo, diante de incidentes críticos positivos e negativos. Estudo exploratório, descritivo, realizado com 24 enfermeiros, que utilizou a Técnica do Incidente Crítico como referencial metodológico. Os resultados foram agrupados em 61 incidentes críticos distribuídos em categorias. Identificou-se que situações relacionadas à liderança interferem no comportamento do enfermeiro de Terapia Intensiva, dentre elas: dificuldade no processo de comunicação, conflitos existentes no dia a dia do exercício profissional, gerenciamento de pessoas e estabelecimento de metas para o alcance da assistência qualificada. Encontrou-se um modelo misto de liderança, o que permite concluir que o conhecimento e a prática dos enfermeiros acerca de teorias/estilos contemporâneos de liderança tornam-se fundamentais, pois facilitam o processo de comunicação, focando nos aspectos comportamentais e crenças, e valorizam a flexibilidade, impactando positivamente os resultados da organização.

[Trattamento farmacologico del disturbo da uso di alcol. Evidenze scientifiche].

PubMed

Attilia, Fabio; Perciballi, Roberta; Rotondo, Claudia; Capriglione, Ida; Iannuzzi, Silvia; Attilia, Maria Luisa; Vitali, Mario; Alessandrini, Giovanni; Scamporrino, Maria Concetta Marcella; Fiore, Marco; Ceccanti, Mauro

2018-01-01

RIASSUNTO. La terapia farmacologica nei pazienti con disturbo da uso di alcol riveste un ruolo centrale nel progetto terapeutico, altamente contestualizzato in un approccio multidisciplinare. Sebbene i trattamenti non farmacologici per la dipendenza da alcol risultino ben strutturati e in continua evoluzione, dal punto di vista medico le possibilità di intervento sono realmente ristrette, con poche molecole a disposizione approvate per il disturbo da uso di alcol: nello specifico, l'acamprostato, il naltrexone e, più recentemente, il nalmefene tra gli anticraving; il disulfiram tra gli avversivanti. Nuovi approcci sperimentali stanno cercando di ampliare tale gamma attraverso l'utilizzo di farmaci off-label. Evidenze scientifiche devono supportare l'indicazione terapeutica, quest'ultima deve dimostrarsi "cucita" sulle esigenze del paziente e sulle comorbilità presenti tenendo conto del profilo bio-psico-sociale individuale. Fondamentale risulta il follow-up per valutare la ritenzione in trattamento e il monitoraggio degli outcome alcologici.

[Guidelines in RA treatment: concepts on safety and recommendations using anti-TNF-alpha inhibitors. Grupo de Estudio de Nuevas Terapias de Enfermedades reumáticas (GENTE)].

PubMed

Díaz-Jouanen, Efraín; Abud-Mendoza, Carlos; Garza-Elizondo, Mario Alberto; Medrano-Ramírez, Gabriel; Burgos-Vargas, Rubén; Orozco-Alcalá, José Javier; Pacheco-Tena, César Francisco; Pineda, Carlos; Pozos-Espíndola, Juan Carlos; Ramos-Niembro, Francisco; Robles-San-Román, Manuel; Santana-Sahagún, Jesús Ernesto

2009-01-01

Recommendations for the use of Disease-Modifying Antirheumatic Drugs (DMARD) with both conventional and biological agents in Rheumatoid Arthritis (RA) must be based on their safety profile, adverse effects, risks, and advantages. With the purpose of presenting the most updated information about the safety of tumor necrosis factor alpha (TNFalpha) antagonists, in this article we summarize the literature published during the last three years about this sort of biological agents in specific clinical situations, such as risk of developing infections, cancer, cardiovascular diseases, and autoimmunity; as well as their administration to patients who will undergo surgical procedures, pregnant and/or breast-feeding women, and patients who need immunizations. Likewise, in this analysis we offer specific recommendations, based on evidence, for the best anti-TNF-alfa management.

Book Review

PubMed Central

Smith, René J.

2006-01-01

Editors Note: This book is written in Spanish and the review is given in both English and Spanish. Both reviews were written by the same individual and essentially have the same content. Code of Practice for Quality Control of Treatment Planning Systems (TPS) in Radiation Therapy, by José Miguel Delgado Rodríguez, Feliciano García Vicente, Esther Millán Cebrián. Sociedad Española de Física Médica. Ramírez de Arellano Editores, S. L. 2005, Madrid, Spain; available. secretaria@sefm.es, 50ε Protocolo para Control de Calidad en Sistemas de Planificación de Terapia con Radiaciones Ionizantes, por José Miguel Delgado Rodríguez, Feliciano García Vicente, Esther Millán Cebrián. Sociedad Española de Física Médica. Ramírez de Arellano Editores, S. L. 2005, Madrid, Spain. secretaria@sefm.es, 50ε

Long survival and immunologic reconstitution following transplantation with syngeneic or allogeneic fetal liver and neonatal spleen cells. [X radiation, mice

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yunis, E.J.; Fernandes, G.; Smith, J.

1976-12-01

Spleen cells from newborn syngeneic and allogeneic mice that lack fully differentiated T lymphocytes can be used as a hematopoietic source to reconstitute both hematopoietic and lymphoid systems of lethally irradiated mice without producing a GVHR. Fetal liver cells from syngeneic and allogeneic mice that lack postthymic T lymphocytes can also be used for hematopoietic and immunologic reconstitution of lethally irradiated mice without producing GVHR. Immunologic deficiency is observed in some experiments in mice given supralethal irradiation (1000 R) and fetal liver as reconstituting hematopoietic tissue. The findings suggest that T cells, at an early stage of differentiation, are moremore » susceptible to tolerance induction than are T lymphocytes at later stages of differentiation and do not, in general, produce GVHR. It is postulated that hematopoietic cells, free of postthymic lymphoid cells, can be used for hematopoietic or immunologic reconstitution and celular engineering without producing GVHD.« less

[Anatomy and histology of salivary glands of Triatominae].

PubMed

Lacombe, D

1999-01-01

Histological studies upon the salivary glands of ten species of triatomine bugs were performed looking for their number and structural organization in different genera. It was possible to evaluate the celular epithelium type of each gland, as well as the merocrine and apocrine secretions of the glands. Secretion run until the hilo and after to salivary pump and hypofaringe. The glandular components, D1, D2 and D3 are always present in the Triatoma, Panstrongylus and Diptelogaster but in Rhodnius there are only the first two pairs of glands. The salivary channels and the hilo are analyzed by histology. The whole pair D3 has a clear valve that regularizes the exit of the secretions to the hilo. According to the genus the valves appear in different locations. They have low and dense epithelium, and their nucleus are rich in chromatin. The secondary channels leaving these valves, are very different, with clear chitinous ringer, low level of chromatin in the nucleus and homogeneous cytoplasm.

Study of system-size effects on the emergent magnetic monopoles and Dirac strings in artificial kagome spin ice

NASA Astrophysics Data System (ADS)

Leon, Alejandro

2012-02-01

In this work we study the dynamical properties of a finite array of nanomagnets in artificial kagome spin ice at room temperature. The dynamic response of the array of nanomagnets is studied by implementing a ``frustrated celular aut'omata'' (FCA), based in the charge model. In this model, each dipole is replaced by a dumbbell of two opposite charges, which are situated at the neighbouring vertices of the honeycomb lattice. The FCA simulations, allow us to study in real-time and deterministic way, the dynamic of the system, with minimal computational resource. The update function is defined according to the coordination number of vertices in the system. Our results show that for a set geometric parameters of the array of nanomagnets, the system exhibits high density of Dirac strings and high density emergent magnetic monopoles. A study of the effect of disorder in the arrangement of nanomagnets is incorporated in this work.

Labeling of lectin receptors during the cell cycle.

PubMed

Garrido, J

1976-12-01

Labeling of lectin receptors during the cell cycle. (Localizabión de receptores para lectinas durante el ciclo celular). Arch. Biol. Med. Exper. 10: 100-104, 1976. The topographic distribution of specific cell surface receptors for concanavalin A and wheat germ agglutinin was studied by ultrastructural labeling in the course of the cell cycle. C12TSV5 cells were synchronized by double thymidine block or mechanical selection (shakeoff). They were labeled by means of lectin-peroxidase techniques while in G1 S, G2 and M phases of the cycle. The results obtained were similar for both lectins employed. Interphase cells (G1 S, G2) present a stlihtly discontinous labeling pattern that is similar to the one observed on unsynchronized cells of the same line. Cells in mitosis, on the contrary, present a highly discontinous distribution of reaction product. This pattern disappears after the cells enters G1 and is not present on mitotic cells fixed in aldehyde prior to labeling.

Intensive care unit team perception of palliative care: the discourse of the collective subject.

PubMed

Gulini, Juliana El Hage Meyer de Barros; Nascimento, Eliane Regina Pereira do; Moritz, Rachel Duarte; Rosa, Luciana Martins da; Silveira, Natyele Rippel; Vargas, Mara Ambrosina de Oliveira

2017-05-25

To learn the perception of health professionals in an intensive care unit towards palliative care. This was a descriptive and qualitative study based on the converging care approach conducted at an intensive care unit in the South of Brazil. Semi-structured interviews were used to investigate the understanding of the professionals about palliative care in this unit. The data were organized and analyzed using the discourse of the collective subject method with the help of Qualiquantisoft® software. Participants included 37 professionals (12 nurses, 11nursing technicians, 5 physical therapists and 9 doctors). The key ideas extracted from the interviews were: care in the end stage of life that avoids futile measures; comfort care; lack of standardized care and lack of team training. The professionals perceived palliative care as appropriate in the last stages of life, with no need for futile treatment or as comfort measures. However, they are aware of the lack of standardization and lack of capacity building in this area, which leads them to conceive palliative care as terminal care, and measures are recommended to break with this stigma. Conhecer a percepção dos profissionais de saúde de uma Unidade de Terapia Intensiva acerca do cuidado paliativo. Pesquisa descritiva, qualitativa do tipo Convergente Assistencial realizada em uma Unidade de Terapia Intensiva da região sul do Brasil. Utilizou-se de entrevista semiestruturada que investigou o entendimento e a compreensão sobre cuidado paliativo nesta unidade. Os dados foram organizados e analisados pela técnica do discurso do sujeito coletivo com auxílio do software Qualiquantisoft®. Participaram do estudo 37 profissionais (12 enfermeiros, 11 técnicos de enfermagem, cinco fisioterapeutas e nove médicos). As ideias centrais extraídas dos relatos: cuidado na fase terminal da vida sem medidas fúteis; cuidados de conforto; falta uniformizar a assistência e falta capacitação para a equipe. Os profissionais percebem o cuidado paliativo apropriado na fase terminal da vida, sem necessidade de medidas fúteis de tratamento e promotoras de conforto. No entanto, estão conscientes da falta de uniformização e da sua capacitação nesta matéria, o que os leva a conceber o paliativismo como cuidado de terminalidade, pelo que se recomendam medidas para romper com este estigma.

The role of thromboelastometry in the assessment and treatment of coagulopathy in liver transplant patients.

PubMed

Zamper, Raffael Pereira Cezar; Amorim, Thiago Chaves; Costa, Luiz Guilherme Villares da; Takaoka, Flávio; Serpa, Ary

2017-01-01

Perioperative monitoring of coagulation is vital to assess bleeding risks, diagnose deficiencies associated with hemorrhage, and guide hemostatic therapy in major surgical procedures, such as liver transplantation. Routine static tests demand long turnaround time and do not assess platelet function; they are determined on plasma at a standard temperature of 37°C; hence these tests are ill-suited for intraoperative use. In contrast, methods which evaluate the viscoelastic properties of whole blood, such as thromboelastogram and rotational thromboelastometry, provide rapid qualitative coagulation assessment and appropriate guidance for transfusion therapy. These are promising tools for the assessment and treatment of hyper- and hypocoagulable states associated with bleeding in liver transplantation. When combined with traditional tests and objective assessment of the surgical field, this information provides ideal guidance for transfusion strategies, with potential improvement of patient outcomes. RESUMO A monitorização perioperatória da coagulação é fundamental para estimar o risco de sangramento, diagnosticar deficiências causadoras de hemorragia e guiar terapias hemostáticas durante procedimentos cirúrgicos de grande porte, como o transplante hepático. Os testes estáticos, comumente usados na prática clínica, são insatisfatórios no intraoperatório, pois demandam tempo e não avaliam a função plaquetária; são determinados no plasma e realizados em temperatura padrão de 37°C. Os métodos que avaliam as propriedades viscoelásticas do sangue total, como o tromboelastograma e a tromboelastometria rotacional, podem suprir as deficiências dos testes estáticos tradicionais, uma vez que permitem avaliar a coagulação de forma rápida e qualitativa, guiando a terapia transfusional de forma adequada. A tromboelastometria rotacional mostrou-se promissora na avaliação e no tratamento de estados de hipercoagulação e hipocoagulação, associados a sangramento no transplante hepático. Estas informações, combinadas com os testes tradicionais e uma avaliação objetiva do campo cirúrgico, promovem um cenário ótimo para guiar as estratégias transfusionais e potencialmente melhorar o desfecho destes pacientes.

[Not Available].

PubMed

De Abajo Larriba, Ana Beatriz; Díaz Rodríguez, Ángel; González-Gallego, Javier; Méndez Rodríguez, Enrique; Álvarez Álvarez, María Jesús; Capón Álvarez, Jessica; Peleteiro Cobo, Beatriz; Mahmoud Atoui, Omar; De Abajo Olea, Serafín; Martínez de Mandojana Hernández, Juan

2016-07-19

Introducción: estimar la prevalencia del tabaquismo y analizar cómo se diagnostican y se trata a los fumadores diagnosticados de EPOC.Métodos: estudio epidemiológico, transversal, multicéntrico (30 centros salud de la provincia de León). Incluyó pacientes mayores de 35 años diagnosticados y tratados de EPOC. Variables analizadas: edad, sexo, hábitat, datos antropométricos, tabaquismo, número de paquetes/año, cooximetría, dependencia (escala analógico-visual), motivación (test de Fagerström), autoeficacia, estado anímico, intentos previos, terapia cognitivo-conductual, tratamiento farmacológico (TSN, bupropión, vareniclina) y recaídas. Los resultados se expresan con sus IC al 95,5%.Resultados: se incluyó a 833 pacientes, el 85,8% varones, edad media: 64,69 (53,66-75,61) años y 20,65 (4,47-36,8) años de evolución de la EPOC. El 86,67% (80,30-93,30) tenían antecedentes de tabaquismo (n = 722), de 35,26 (17,87-52,64) años de evolución, con consumo medio 28,36 (9,60-46,86) paquetes año, p < 0,001, siendo el 58% fumadores severos. El 57,4% (53,90-60,60) son exfumadores. El 29,3% (26,40-32,70) fumadores activos declarados vs. 35,11% (33,90-37,12) fumadores diagnosticados por cooximetría p < 0,05. Los 288 fumadores activos, presentaban baja motivación (49,80%), alta dependencia (49,5%), actitud negativa (52,60%), bajo estado de ánimo (32,05%), con 2,72 (1,74-3,67) intentos para dejar de fumar, p < 0,0001. La terapia conductivo-conductual (TCC) combinado con tratamiento farmacológico se realizó en el 55,8% (52,2-54,9), p < 0,05; La intervención más efectiva fue TCC combinada con vareniclina logrando una abstinencia del 29,86%. En total dejaron de fumar un 51,05% (49,49-52,70) de los pacientes con EPOC, p < 0,001.Conclusiones: la prevalencia de tabaquismo en la EPOC en nuestro medio continúa siendo inadmisiblemente elevada. Es necesaria una mayor implicación para disminuir su impacto en la salud de estos pacientes.

Potential intravenous drug interactions in intensive care.

PubMed

Moreira, Maiara Benevides; Mesquita, Maria Gefé da Rosa; Stipp, Marluci Andrade Conceição; Paes, Graciele Oroski

2017-07-20

To analyze potential intravenous drug interactions, and their level of severity associated with the administration of these drugs based on the prescriptions of an intensive care unit. Quantitative study, with aretrospective exploratory design, and descriptive statistical analysis of the ICU prescriptions of a teaching hospital from March to June 2014. The sample consisted of 319 prescriptions and subsamples of 50 prescriptions. The mean number of drugs per patient was 9.3 records, and a higher probability of drug interaction inherent to polypharmacy was evidenced. The study identified severe drug interactions, such as concomitant administration of Tramadol with selective serotonin reuptake inhibitor drugs (e.g., Metoclopramide and Fluconazole), increasing the risk of seizures due to their epileptogenic actions, as well as the simultaneous use of Ranitidine-Fentanyl®, which can lead to respiratory depression. A previous mapping of prescriptions enables the characterization of the drug therapy, contributing to prevent potential drug interactions and their clinical consequences. Analisar as potenciais interações medicamentosas intravenosas e seu grau de severidade associadas à administração desses medicamentos a partir das prescrições do Centro de Terapia Intensiva. Estudo quantitativo, tipologia retrospectiva exploratória, com análise estatística descritiva das prescrições medicamentosas do Centro de Terapia Intensiva de um Hospital Universitário, no período de março-junho/2014. A amostra foi composta de 319 prescrições e subamostras de 50 prescrições. Constatou-se que a média de medicamentos por paciente foi de 9,3 registros, e evidenciou-se maior probabilidade para ocorrência de interação medicamentosa inerente à polifarmácia. O estudo identificou interações medicamentosas graves, como a administração concomitante de Tramadol com medicamentos inibidores seletivos da recaptação da serotonina, (exemplo: Metoclopramida e Fluconazol), aumentando o risco de convulsões devido às suas ações epileptogênicas, além do uso simultâneo de Ranitidina-Fentanil®, que pode ocasionar depressão respiratória. O mapeamento prévio das prescrições possibilita a caracterização da terapêutica medicamentosa, contribuindo para obstar as potenciais interações medicamentosas e suas consequências clínicas.

PubMed

Gómez, Luis Alberto; Montoya, Gladis; Rivera, Hernán Mauricio; Hernández, Juan Carlos

2017-04-01

Introducción. El virus del Zika (ZIKV) es un flavivirus con envoltura, transmitido a los seres humanos principalmente por el vector Aedes aegypti. La infección por ZIKV se ha asociado con un gran neurotropismo y con efectos neuropáticos, como el síndrome de Guillain-Barré en el adulto y la microcefalia fetal y posnatal, así como con un síndrome de infección congénita similar al producido por el virus de la rubéola (RV).Objetivo. Comparar las estructuras moleculares de la proteína de envoltura E del virus del Zika (E-ZIKV) y de la E1 del virus de la rubéola (E1-RV), y plantear posibles implicaciones en el neurotropismo y en las alteraciones del sistema nervioso asociadas con el ZIKV.Materiales y métodos. La secuencia de aminoácidos de la proteína E-ZIKV (PDB: 5iZ7) se alineó con la de la glucopreteína E1 del virus de la rubéola (PDB: 4ADG). Los elementos de la estructura secundaria se determinaron usando los programas Vector NTI Advance®, DSSP y POSA, así como herramientas de gestión de datos (AlignX®). Uno de los criterios principales de comparación y alineación fue la asignación de residuos estructuralmente equivalentes, con más de 70 % de identidad.Resultados. La organización estructural de la proteína E-ZIKV (PDB: 5iZ7) fue similar a la de E1-RV (PDB: 4ADG) (70 a 80 % de identidad), y se observó una correspondencia con la estructura definida para las glucoproteínas de fusión de membrana de clase II de los virus con envoltura. E-ZIKV y E1-RV exhibieron elementos estructurales de fusión muy conservados en la región distal del dominio II, asociados con la unión a los receptores celulares de entrada del virus de la rubéola (glucoproteína de mielina del oligodendrocito, Myelin Oligodendrocyte Glycoprotein, MOG), y con los receptores celulares Axl del ZIKV y de otros flavivirus.Conclusión. La comparación de las proteínas E-ZIKV y E1-RV es un paso necesario hacia la definición de otros factores moleculares determinantes del neurotropismo y la patogenia del ZIKV, el cual puede contribuir a generar estrategias de diagnóstico, prevención y tratamiento de las complicaciones neurológicas inducidas por el ZIKV.

Dental experience and self-perceived dental care needs of patients with angioedema.

PubMed

Lodi, G; Sardella, A; Bez, C; Demarosi, F; Cicardi, M; Carrassi, A

2001-01-01

The purpose of this study was to investigate the self-perceived dental care needs and dental experiences of patients with angioedema. At the 1998 annual meeting of the Voluntary Association for the Fight, Study and Treatment of Hereditary Angioedema ("Associazione volontaria per la lotta, lo studio e la terapia dell'angioedema ereditario"), a self-administered questionnaire was distributed to participants affected by hereditary or acquired angioedema. Fifty-seven persons completed the questionnaire (37 females, 20 males; mean age, 39 +/- 17 yrs; range, 5-76). The vast majority (91%) had the hereditary form of the disease. One-third of the respondents had some problems in obtaining oral treatment, with one person having been refused care. About half of the group had experienced an acute attack following dental treatment. Preventive measures needed improvement in about two-thirds of respondents. More than half (58%) of the group perceived a need for dental care. We conclude that persons with angioedema may experience difficulty in obtaining dental treatment, a common cause of acute attacks.

[Un processo che può gettare luce sulla cosiddetta 'paura di sé' nel disturbo ossessivo-compulsivo: l'Identificazione Retrospettiva delle Motivazioni e delle Inclinazioni].

PubMed

Mannino, Gherardo; Guerini, Rossella

2018-01-01

RIASSUNTO. Al fine di comprendere meglio la psicopatologia del disturbo ossessivo-compulsivo (DOC), in anni recenti è stata prestata una crescente attenzione alla cosiddetta "paura di sé" (fear of self), vale a dire la paura che le persone con DOC nutrono di ospitare dentro di sé aspetti inaccettabili. Tuttavia, l'esatta dinamica di questo fenomeno ancora non è chiara: di conseguenza, allo scopo di delucidarla meglio, sarà qui descritto uno specifico processo psicologico denominato Identificazione Retrospettiva delle Motivazioni e delle Inclinazioni (IRMI). Quando un paziente con DOC valuta in qualche modo come inaccettabile una propria esperienza interna (pensieri, emozioni, immagini mentali, ecc.) o un proprio comportamento, identificherà retrospettivamente le presunte motivazioni/inclinazioni negative che sarebbero state all'origine di quell'esperienza o comportamento. L'IRMI non solo aiuta a comprendere meglio il fenomeno della "paura di sé", ma possiede anche importanti implicazioni per la terapia.

Structure of the vault, a ubiquitous celular component.

PubMed

Kong, L B; Siva, A C; Rome, L H; Stewart, P L

1999-04-15

The vault is a ubiquitous and highly conserved ribonucleoprotein particle of approximately 13 MDa. This particle has been shown to be upregulated in certain multidrug-resistant cancer cell lines and to share a protein component with the telomerase complex. Determination of the structure of the vault was undertaken to provide a first step towards understanding the role of this cellular component in normal metabolism and perhaps to shed some light on its role in mediating drug resistance. Over 1300 particle images were combined to calculate an approximately 31 A resolution structure of the vault. Rotational power spectra did not yield a clear symmetry peak, either because of the thin, smooth walls or inherent flexibility of the vault. Although cyclic eightfold (C8) symmetry was imposed, the resulting reconstruction may be partially cylindrically averaged about the eightfold axis. Our results reveal the vault to be a hollow, barrel-like structure with two protruding caps and an invaginated waist. Although the normal cellular function of the vault is as yet undetermined, the structure of the vault is consistent with either a role in subcellular transport, as previously suggested, or in sequestering macromolecular assemblies.

Social support of adults and elderly with chronic kidney disease on dialysis.

PubMed

Silva, Simone Márcia da; Braido, Natalia Fernanda; Ottaviani, Ana Carolina; Gesualdo, Gabriela Dutra; Zazzetta, Marisa Silvana; Orlandi, Fabiana de Souza

2016-08-08

to evaluate the instrumental and emotional social support of patients with chronic kidney disease on hemodialysis. descriptive cross-sectional study. The sample was sized for convenience and included 103 participants under treatment in a Renal Replacement Therapy Unit. Data were collected through individual interviews, using the Social Support Scale. the mean scores of the emotional and instrumental social support were 3.92 (± 0.78) and 3.81 (± 0.69) respectively, an indication of good support received. The most frequent sources of instrumental and emotional social support mentioned by participants were partners, spouse, companion or boyfriend and friends. patients with chronic kidney disease have high social support, both instrumental and emotional, and the main support comes from the family. avaliar o suporte social instrumental e emocional de pacientes renais crônicos em tratamento hemodialítico. estudo descritivo, de corte transversal. A amostra dimensionada por conveniência foi composta por 103 participantes em tratamento em uma Unidade de Terapia Renal Substitutiva. Os dados foram coletados por meio de entrevista individual, utilizando-se a Escala de Suporte Social. o escore médio do suporte social emocional e instrumental foi de 3,92 (±0,78) e foi 3,81 (± 0,69) respectivamente, sendo um indicativo de bom suporte recebido. Entre as fontes mais frequentes de suporte social instrumental e emocional mencionadas pelos participantes encontram-se os parceiros, cônjuge, companheiro ou namorado e amigos. os pacientes com doença renal crônica apresentam elevado apoio social, tanto instrumental quanto emocional, sendo a principal forma de apoio proveniente da família. evaluar el apoyo social instrumental y emocional de los enfermos renales crónicos en hemodiálisis. estudio descriptivo, de cohorte transversal. La muestra ha sido dimensionada por conveniencia y compuesta de 103 participantes en tratamiento en una Unidad de Terapia de Reemplazo Renal. Los datos se recopilaron mediante entrevista individual, utilizando la Escala de Apoyo Social. la puntuación media del apoyo social emocional e instrumental fue de 3,92 (± 0,78) y 3,81 (± 0,69), respectivamente, lo que indica un buen apoyo recibido. Entre las fuentes más frecuentes de apoyo social instrumental y emocional mencionadas por los participantes figuran pareja, cónyuge, compañero o novio y amigos. los pacientes con enfermedad renal crónica tienen un fuerte apoyo social, tanto instrumental como emocional, y la principal forma de apoyo proviene de la familia.

Antibiotic consumption and resistance: results of the SPIN-UTI project of the GISIO-SItI.

PubMed

Agodi, Antonella; Auxilia, Francesco; Barchitta, Martina; Brusaferro, Silvio; D'Errico, Marcello Mario; Montagna, Maria Teresa; Pasquarella, Cesira; Tardivo, Stefano; Mura, Ida

2015-01-01

To evaluate trends and association between antibiotic consumption and resistance during an eight-year period, from 2006 to 2013. Prospective multicenter study. Intensive Care Units (ICUs) participating in the four editions of the Italian nosocomial infections surveillance in the ICU Network (Sorveglianza Prospettica delle Infezioni Nosocomiali nelle Unità di Terapia Intensiva, SPIN-UTI project). The isolation density of selected species of microorganisms, antibiotic resistance rates (RRs), incidence density of resistant isolates and antimicrobial usage density were calculated. RRs of carbapenem-resistant Acinetobacter baumannii, of carbapenem-resistant Klebsiella pneumoniae, of third-generation cephalosporin (3GC)-resistant K. pneumoniae and of 3GC-resistant Escherichia coli showed significant increasing trends (p ≤0.001). The consumption of each antibiotic class varied with years, although not significantly. Significant strongly positive correlations were detected between RRs and antibiotic consumption. The present study describes high RRs and increasing trends of resistant microorganisms and highlights the need for continuous comprehensive strategies targeting not only the prudent use of antibiotics, but also infection control measures to limit the epidemic spread of resistant isolates.

Gene therapy coming of age in Latin America.

PubMed

Podhajcer, Osvaldo; Pitossi, Fernando; Agilar-Cordova, Estuardo

2002-08-01

"Gene Therapy in Latin America: From the Bench to the Clinic," a meeting sponsored by the Wellcome Trust and the United Nations University through the Biotechnology Program for Latin America and the Caribbean, took place in Buenos Aires, Argentina from May 20 to 22. This symposium, which was hosted by Osvaldo Podhajcer and Fernando Pitossi,had more than 150 basic scientists and physician-scientists from academia, government and industry in Latin America, similar to the first meeting of the Asociacion Iberoamericana de Terapia Génica (Iberoamerican Society of Gene Therapy, AITG) held in Guadalajara, México, two years ago. Participants represented Argentina, Mexico, Brazil, Chile, Uruguay, Costa Rica, Colombia, Venezuela, and Guatemala, with guests from the United States and Europe. All came together to discuss the latest developments in this field in the region. A primary objective of this gathering was to bring together Latin American scientists involved in gene therapy to strengthen continental collaborations and to further disseminate the scientific expertise available in Latin America. The symposium was followed by a 10-day practical course for 25 students from all over Latin America.

Glass-mica composite: a new structural thermal-insulating material for building applications

DOE Office of Scientific and Technical Information (OSTI.GOV)

Low, N.M.P.

1981-12-01

Homogeneous, rigid glass-mica composites have been synthesized from mixtures of Canadian natural mica flakes of the phlogopite type and ground glass powders prepared from recycled soda-lime waste glasses by a simple sintering process. By means of selection of compositions and processing techniques, composites can be fabricated into products that exhibit a celular structure, a highly densified structure, and multilayer and sandwich structures. The cellular structure composite has a thermal conductivity in the range of 0.165 to 0.230 W/m /sup 0/C when measured over the temperature range 25 to 180/sup 0/C, and a compressive strength of about 0.874 MPa; the highlymore » densified composite, on the other hand, has a thermal conductivity in the range of 0.155 to 0.330 W/m /sup 0/C, a compressive strength in excess of 40 MPa, and an instantaneous coefficient of thermal expansion of 5.8 X 10/sup -6///sup 0/C at 100/sup 0/C. These glass-mica composites exhibit qualities such as insulating efficiency, safety, mechanical strength, and durability that are suitable for engineering applications in building structures or other systems.« less

Phenotypic stability and plasticity in GMP-derived cells as determined by their underlying regulatory network.

PubMed

Ramírez, Carlos; Mendoza, Luis

2018-04-01

Blood cell formation has been recognized as a suitable system to study celular differentiation mainly because of its experimental accessibility, and because it shows characteristics such as hierarchical and gradual bifurcated patterns of commitment, which are present in several developmental processes. Although hematopoiesis has been extensively studied and there is a wealth of molecular and cellular data about it, it is not clear how the underlying molecular regulatory networks define or restrict cellular differentiation processes. Here, we infer the molecular regulatory network that controls the differentiation of a blood cell subpopulation derived from the granulocyte-monocyte precursor (GMP), comprising monocytes, neutrophils, eosinophils, basophils and mast cells. We integrate published qualitative experimental data into a model to describe temporal expression patterns observed in GMP-derived cells. The model is implemented as a Boolean network, and its dynamical behavior is studied. Steady states of the network can be clearly identified with the expression profiles of monocytes, mast cells, neutrophils, basophils, and eosinophils, under wild-type and mutant backgrounds. All scripts are publicly available at https://github.com/caramirezal/RegulatoryNetworkGMPModel. lmendoza@biomedicas.unam.mx. Supplementary data are available at Bioinformatics online.

Initial biocompatibility of plasma polymerized hexamethyldisiloxane films with different wettability

NASA Astrophysics Data System (ADS)

Krasteva, N. A.; Toromanov, G.; Hristova, K. T.; Radeva, E. I.; Pecheva, E. V.; Dimitrova, R. P.; Altankov, G. P.; Pramatarova, L. D.

2010-11-01

Understanding the relationships between material surface properties, behaviour of adsorbed proteins and cellular responses is essential to design optimal material surfaces for tissue engineering. In this study we modify thin layers of plasma polymerized hexamethyldisiloxane (PPHMDS) by ammonia treatment in order to increase surface wettability and the corresponding biological response. The physico-chemical properties of the polymer films were characterized by contact angle (CA) measurements and Fourier Transform Infrared Spectroscopy (FTIR) analysis.Human umbilical vein endothelial cells (HUVEC) were used as model system for the initial biocompatibility studies following their behavior upon preadsorption of polymer films with three adhesive proteins: fibronectin (FN), fibrinogen (FG) and vitronectin (VN). Adhesive interaction of HUVEC was evaluated after 2 hours by analyzing the overall cell morphology, and the organization of focal adhesion contacts and actin cytoskeleton. We have found similar good cellular response on FN and FG coated polymer films, with better pronounced vinculin expression on FN samples while. Conversely, on VN coated surfaces the wettability influenced significantly initial celular interaction spreading. The results obtained suggested that ammonia plasma treatment can modulate the biological activity of the adsorbed protein s on PPHMDS surfaces and thus to influence the interaction with endothelial cells.

A comparative genomic hybridization study in a 46,XX male.

PubMed

Rigola, M Angels; Carrera, Marta; Ribas, Isabel; Egozcue, Josep; Miró, Rosa; Fuster, Carme

2002-07-01

To identify Y chromosome material in an azoospermic male with an XX karyotype. Case report. Faculty of medicine and Centro de Patologia Celular (CPC) medical center. A 33-year-old man with infertility. G-banding, fluorescence in situ hybridization (FISH), polymerase chain reaction (PCR), and comparative genomic hybridization (CGH). FISH for X and Y chromosomes, PCR for the SRYgene and amelogenin gene in the Xp (AMGX) and (AMGY), and losses or gains with CGH. FISH analysis using X and Y chromosome-specific probes showed an X chromosome containing Y chromosome sequences on the top of the short arm; this Y chromosome region was not visible by conventional cytogenetic analysis. PCR amplification of DNA showed the presence of the sex-determining region of the Y chromosome (SRY) and the amelogenin gene in the pseudoautosomal boundary of the X chromosome (AMGX). CGH confirmed the presence of the chromosome region Yp11.2-pter and detected the presence of the two otherwise normal X chromosomes. The two Xpter (XPAR1) pseudoautosomal regions present in this XX male suggest the need to reevaluate XX males using CGH and PCR to characterize the clinical variability in XX males due to genes other than those located on the Y chromosome.

[Flow cytometry in datecting lymph node micrometastasis in colorectal cancer].

PubMed

Sun, Q; Ding, Y; Zhang, J

2001-01-25

To study the methodology and significance of flow cytometry in detecting lymph node micrometastasis of colorectal cancer. One hundred sixty-two cellular suspensions were prepared with lymph nodes which were resected radically on 25 patients with colorectal cancer and in which no cancer cells were found by HE staining. Different concentrations of cultured Lovo colorectal cancer cells were added into the celular suspension prepared from lymph node tissue of persons without colorectal cancer in order to prepare a control model. Dual staining with CK/FTTC and PI was made to the sedimetns from those 2 kinds of suspension. Flow cytometry was used to detect cancer cells. An ideal correlation was obtained between the detection value and the theoretical value of cancer cells in the specimen suspensions and control models (r = 0.097 6) with a sensitivity rate of 10/10(5). Cancer cells were detected from 7 out of the 25 patients and 30 of the 162 cellular suspensions. The detection rate was correlated with the size and infiltrating depth of the cancer. Flow cytometry is a reliable, rapid, and quantitative method for detecting lymph node micrometastasis in colorectal cancer.

Lesiones subcutáneas dolorosas en paciente con melanoma metastásico: un caso de paniculitis linfocítica asociado a vemurafenib.

PubMed

Benavente-Villegas, Felipe; Ferrando-Roca, Francisco; Dolz-Gaitón, Raquel; Royo-Peiró, María

2017-10-15

Vemurafenib ha probado ser una herramienta útil en el tratamiento de melanoma metastásico con mutación BRAF-V600E. Los efectos adversos incluyen artralgias, fatiga y toxicidad cutánea, siendo infrecuente la paniculitis. Presentamos el caso de una paciente de 43 años con melanoma metastásico que desarrolla lesiones subcutáneas dolorosas en miembros inferiores y superiores, asociadas a clínica sistémica después de 2 semanas de inicio de tratamiento con Vemurafenib + Cobimetinib. La histología demostró paniculitis linfocitaria septal y lobulillar. La paciente tuvo mala tolerancia al tratamiento anti diana a dosis plenas, requiriendo su ajuste, generando una corticodependencia para controlar sintomatología, y que finalmente obligó a la descontinuación de la terapia dirigida contra melanoma.  A la fecha, se han descrito 29 casos en la literatura de paniculitis asociada a vemurafenib, siendo la mayoría paniculitis neutrofílicas con adecuado control de sintomatología asociando antiinflamatorios no esteroidales y/o corticoides orales sin requerir en su mayoría modificación de la terapia contra melanoma; sin embargo hay que tener presente que pueden haber casos con mala evolución que obligan a la reducción de dosis de vemurafenib y descontinuar el tratamiento, como ha ocurrido en nuestro reporte.Vemurafenib has proven to be a useful tool in the treatment of metastatic melanoma with BRAF-V600E mutation. Adverse effects include arthralgia, fatigue, and skin toxicity; panniculitis is a rare complication. We present the case of a 43-year-old patient with metastatic melanoma who developed painful subcutaneous nodules of the lower and upper limbs and associated systemic clinical symptoms after 2 weeks of treatment with vemurafenib plus cobimetinib. Histology showed a septal and lobular lymphocytic panniculitis.The patient had poor tolerance of the full-dose treatment, requiring its adjustment. Systemic corticosteroids were required to control symptomatology, which finally forced the discontinuation of the medication.To date, 29 cases have been described in the literature of panniculitis associated with vemurafenib. Most of these have been neutrophilic panniculitis, but adequate control of symptoms is usually achieved with nonsteroidal anti-inflammatory drugs and/or oral corticosteroids without requiring modification of melanoma therapy. However, it must be borne in mind that there may be cases that force the reduction and discontinuation ofvemurafenib treatment. We believe that this histological variant of lymphocytic panniculitis and its poor response to decrease in vemurafenib makes this case unusual and instructive.

[Unicentric Castleman's disease in cervical back space neck].

PubMed

Chamorro-Oscullo, Jenny; Robles-Ramírez, Fernando; Valenzuela-Tamariz, Jorge; Sánchez-Cortázar, Julián Antonio; Gómez-Pérez, Guadalupe

2017-01-01

Castleman´s disease is a rare, benign condition of lymphoid tissue. There are two clinical types: unicentric and multicentric with three histological variants, hyaline-vascular, plasma celular and mixed. The most common sites of this are mediastinum, adbomen and neck. Magnetic resonance imaging is well suited to depict the characteristics of the masses and their relationship to adjacent structures. The knowledge of this disease and its inclusión in the differential diagnosis from other neck masses will contribute to the therapeutic approach. A 21 years old female patient with a left neck mass characterized by magnetic resonance as solid, heterogeneous, vascularized lesión, pre dominantly isointensa on T1-weighted images an high signal on T2-weighted images and fat sat that demonstrate moderate enhancement after contraste material administration located in posterior space of the neck with extensión at thoracic outlet displacing structures of carotid, anterior cervical and viceral spaces. She underwent complete surgical resectión of the mass with histopathological diagnosis of hyaline-vascular type of Castleman´s disease. Magnetic resonance is well suited to depict characteristic and the extent of mass in the neck contributing to narrow the differential diagnosis. Imaging findings, especially of magnetic resonance are very important to choose the treatment of Castleman´s disease.

Strip Ionization Chamber as Beam Monitor in the Proton Therapy Eye Treatment

NASA Astrophysics Data System (ADS)

Marchetto, F.; Cirio, R.; Garella, M. A.; Giordanengo, S.; Boriano, A.; Givehchi, N.; La Rosa, A.; Peroni, C.; Donetti, M.; Bourhaleb, F.; Pitta', G.; Cirrone, G. A. P.; Cuttone, G.; Raffaele, L.; Sabini, M. G.; Valastro, L.

2006-04-01

Since spring 2002, ocular pathologies have been treated in Catania at the Centro di AdroTerapia e Applicazioni Nucleari Avanzate (CATANA) within a collaboration between INFN Laboratori Nazionali del Sud (LNS), Physics Department, Ophthalmology Institute, Radiology Institute of the Catania University and CSFNSM Catania. A beam line from a 62 MeV Superconducting Cyclotron is used to treat shallow tumors. The beam is conformed to the tumor shape with a passive delivery system. A detector system has been developed in collaboration with INFN-Torino to be used as real time beam monitor. The detector, placed upstream of the patient collimator, consists of two parallel plate ionization chambers with the anode segmented in strips. Each anode is made of 0.5 mm-wide 256 strips corresponding to (12.8 × 12.8) cm2 sensitive area. With the two strip ionization chambers one can measure the relevant beam parameters during treatment to probe both asymmetry and flatness. In the test carried out at CATANA the detector has been used under different and extreme beam conditions. Preliminary results are given for profiles and skewness, together with a comparison with reference detectors.

Retirada do leito após a descontinuação da ventilação mecânica: há repercussão na mortalidade e no tempo de permanência na unidade de terapia intensiva?

PubMed

Soares, Thiago Rios; Avena, Kátia de Miranda; Olivieri, Flávia Milholo; Feijó, Luciana Ferreira; Mendes, Kristine Menezes Barberino; Souza Filho, Sydney Agareno de; Gomes, André Mansur de Carvalho Guanaes

2010-03-01

To describe the withdrawal of the bed frequency in mechanic ventilation patients and its impact on mortality and length of stay in the intensive care unit. This was a retrospective cohort study in mechanical ventilation patients. Clinical and epidemiological variables, withdrawal of bed related motor therapy, intensive care unit length of stay and mortality were evaluated. We studied 91 patients, mean age of 62.5± 18.8 years, predominantly female (52%) and mean intensive care unit length of stay of 07 days (95% CI, 8-13 days). Considering the withdrawal of the bed or not, no difference was observed between groups regarding length of stay in intensive care unit. Patients who were withdrawn of bed had a lower clinical severity. Their mortality rate was 29.7%. The not withdrawn of bed group had higher both actual and expected mortality. Patients withdrawn of bed following mechanical ventilation discontinuation showed lower mortality. It is suggested that early intensive care unit mobilization and withdrawal of bed should be stimulated.

Veno-occlusive disease nurse management: development of a dynamic monitoring tool by the GITMO nursing group.

PubMed

Botti, Stefano; Orlando, Laura; Gargiulo, Gianpaolo; Cecco, Valentina De; Banfi, Marina; Duranti, Lorenzo; Samarani, Emanuela; Netti, Maria Giovanna; Deiana, Marco; Galuppini, Vera; Pignatelli, Adriana Concetta; Ceresoli, Rosanna; Vedovetto, Alessio; Rostagno, Elena; Bambaci, Marilena; Dellaversana, Cristina; Luminari, Stefano; Bonifazi, Francesca

2016-01-01

Veno-occlusive disease (VOD) is a complication arising from the toxicity of conditioning regimens that have a significant impact on the survival of patients who undergo stem cell transplantation. There are several known risk factors for developing VOD and their assessment before the start of conditioning regimens could improve the quality of care. Equally important are early identification of signs and symptoms ascribable to VOD, rapid diagnosis, and timely adjustment of support therapy and treatment. Nurses have a fundamental role at the stages of assessment and monitoring for signs and symptoms; therefore, they should have documented skills and training. The literature defines nurses' areas of competence in managing VOD, but in the actual clinical practice, this is not so clear. Moreover, there is an intrinsic difficulty in managing VOD due to its rapid and often dramatic evolution, together with a lack of care tools to guide nurses. Through a complex evidence-based process, the Gruppo Italiano per il Trapianto di Midollo Osseo (GITMO), cellule staminali emopoietiche e terapia cellulare nursing board has developed an operational flowchart and a dynamic monitoring tool applicable to haematopoietic stem cell transplantation patients, whether they develop this complication or not.

Veno-occlusive disease nurse management: development of a dynamic monitoring tool by the GITMO nursing group

PubMed Central

Botti, Stefano; Orlando, Laura; Gargiulo, Gianpaolo; Cecco, Valentina De; Banfi, Marina; Duranti, Lorenzo; Samarani, Emanuela; Netti, Maria Giovanna; Deiana, Marco; Galuppini, Vera; Pignatelli, Adriana Concetta; Ceresoli, Rosanna; Vedovetto, Alessio; Rostagno, Elena; Bambaci, Marilena; Dellaversana, Cristina; Luminari, Stefano; Bonifazi, Francesca

2016-01-01

Veno-occlusive disease (VOD) is a complication arising from the toxicity of conditioning regimens that have a significant impact on the survival of patients who undergo stem cell transplantation. There are several known risk factors for developing VOD and their assessment before the start of conditioning regimens could improve the quality of care. Equally important are early identification of signs and symptoms ascribable to VOD, rapid diagnosis, and timely adjustment of support therapy and treatment. Nurses have a fundamental role at the stages of assessment and monitoring for signs and symptoms; therefore, they should have documented skills and training. The literature defines nurses’ areas of competence in managing VOD, but in the actual clinical practice, this is not so clear. Moreover, there is an intrinsic difficulty in managing VOD due to its rapid and often dramatic evolution, together with a lack of care tools to guide nurses. Through a complex evidence-based process, the Gruppo Italiano per il Trapianto di Midollo Osseo (GITMO), cellule staminali emopoietiche e terapia cellulare nursing board has developed an operational flowchart and a dynamic monitoring tool applicable to haematopoietic stem cell transplantation patients, whether they develop this complication or not. PMID:27594906

[Not Available].

PubMed

Torres Díaz, Cristina V; Martín Peña, Gonzalo; Ezquiaga, Elena; Navas García, Marta; García de Sola, Rafael

2016-07-19

Gracias a los avances técnicos en técnicas neuroquirúrgicas, y debido a que el diagnóstico y la clasificación de las enfermedades psiquiátricas han evolucionado significativamente a lo largo de las últimas décadas, se están desarrollando tratamientos a nivel experimental para aquellos pacientes resistentes al manejo conservador.La anorexia nerviosa es una enfermedad de prevalencia creciente, con la tasa de mortalidad más elevada dentro de los trastornos psiquiátricos, y con aproximadamente un 20% de pacientes que presentan una evolución tórpida. Para estos pacientes que no responden a manejo conservador, la estimulación cerebral profunda ha surgido como una alternativa terapéutica, si bien la literatura especializada al respecto es escasa.A continuación presentamos una revisión de la fisiopatología de la anorexia nerviosa, así como de los distintos tratamientos neuroquirúrgicos realizados a lo largo de la historia. Se detalla la perspectiva de tratamiento quirúrgico actual, así como los aspectos éticos que se han de considerar en relación con el surgimiento de estas nuevas terapias.

Supervised physical therapy in women treated with radiotherapy for breast cancer.

PubMed

Leal, Nara Fernanda Braz da Silva; Oliveira, Harley Francisco de; Carrara, Hélio Humberto Angotti

2016-08-15

to evaluate the effect of physical therapy on the range of motion of the shoulders and perimetry of the upper limbs in women treated with radiotherapy for breast cancer. a total of 35 participants were randomized into two groups, with 18 in the control group (CG) and 17 in the study group (SG). Both of the groups underwent three evaluations to assess the range of motion of the shoulders and perimetry of the upper limbs, and the study group underwent supervised physical therapy for the upper limbs. the CG had deficits in external rotation in evaluations 1, 2, and 3, whereas the SG had deficits in flexion, abduction, and external rotation in evaluation 1. The deficit in abduction was recovered in evaluation 2, whereas the deficits in all movements were recovered in evaluation 3. No significant differences in perimetry were observed between the groups. the applied supervised physical therapy was effective in recovering the deficit in abduction after radiotherapy, and the deficits in flexion and external rotation were recovered within two months after the end of radiotherapy. Registration number of the clinical trial: NCT02198118. avaliar o efeito da fisioterapia na amplitude de movimento do ombro e na perimetria do membro superior, aplicada durante o período da radioterapia nas mulheres em tratamento para o câncer de mama. 35 voluntárias foram randomizadas em dois grupos, 18 para o grupo controle e 17 para o grupo de estudo. Os dois grupos foram submetidos a três avaliações da amplitude de movimento do ombro e perimetria do membro superior, sendo o grupo de estudo também submetido à fisioterapia supervisionada para os membros superiores. o grupo controle apresentou déficit entre os membros para o movimento de rotação externa nas avaliações 1, 2 e 3. O grupo de estudo apresentou déficit entre os membros para os movimentos de flexão, abdução e rotação externa na avaliação 1. Houve recuperação do déficit de movimento de abdução na avaliação 2 e, na avaliação 3, os déficits de todos os movimentos estavam recuperados. Na análise da perimetria não foi observada diferença significativa. o protocolo fisioterapêutico supervisionado aplicado foi efetivo na recuperação do déficit de abdução pós-radioterapia e de flexão e rotação externa quando avaliados até 2 meses após o término da radioterapia. Número do registro do ensaio clínico: NCT02198118. evaluar el efecto de la terapia física en el rango de movimiento de los hombros y la perimetría de las extremidades superiores en mujeres tratadas con radioterapia debido a cáncer de mama. un total de 35 participantes fueron aleatorizadas en dos grupos, 18 en el grupo control y 17 en el grupo de estudio. Ambos grupos fueron sometidos a tres evaluaciones para evaluar el rango de movimiento de los hombros y la perimetría de las extremidades superiores, y el grupo de estudio fue sometido a terapia física supervisada de las extremidades superiores. el grupo de control tuvo déficits en la rotación externa en la evaluación 1, 2, y 3, mientras que el grupo de estudio tuvo déficits en la flexión, abducción y rotación externa en la evaluación 1. El déficit en la abducción fue recuperado en la evaluación 2, mientras que los déficits en todos los movimientos fueron recuperados en la evaluación 3. No se observaron diferencias significativas en la perimetría. la terapia física supervisada aplicada fue efectiva en la recuperación del déficit en la abducción después de la radioterapia y los déficits en flexión y rotación externa fueron recuperados dos meses después de terminada la radioterapia. Número de registro del ensayo clínico: NCT02198118.

The effects of training in time-limited dynamic psychotherapy: changes in therapeutic outcome.

PubMed

Bein, E; Anderson, T; Strupp, H; Henry, W; Schacht, T; Binder, J; Butler, S

2000-02-01

The present study explored the effects on therapeutic outcomes of training therapists in brief manualized therapy. As part of the Vanderbilt II project, each of 16 therapists (8 psychiatrists and 8 clinical psychologists) treated 2 moderately disturbed adult patients using his or her customary short-term treatment methods; they then received a year of training in a manualized form of brief dynamic therapy, Time-Limited Dynamic Psychotherapy (TLDP); finally, they administered TLDP to 2 additional patients. It was hypothesized that training would result in improved outcomes generally and that differentially greater improvement would be seen in patients commonly considered less suitable for brief dynamic therapy. Outcome data obtained at termination failed to support either hypothesis. Measurements of interpersonal dependency obtained at a one-year follow-up were consistent with the first hypothesis, but the follow-up data were inconsistent with the second. A systematic review of the 32 posttraining cases suggested that the majority of the therapists had not achieved basic competence at TLDP. Die hier beschriebene Studie untersucht die Wirkungen eines Trainings in manualisierter Kurzzeitherapie auf das Therapierergebnis. Als Teil des Vanderbilt II Projektes behandelten jeweils 16 Therapeuten (8 Psychiater und 8 klinische Psychologen) zwei mittelgradig beeinrächtigte erwachsene Patienten mit den ihnen vertrauten Kurzzeitbehandlungsmethoden. Danach wurden sie über ein Jahr in einer manualisierten Form psychodynamischer Kurzzeittherapie ausgebildet und wandten diese Therapie auf zwei weitere Patienten an. Es wurde angenommen, dass die Ausbildung in besseren Ergebnisdaten, die bei Ende der Therapie erhoben wurden, konnten diese Hypothese nicht bestätigen. Maße für die interpersonale Abhängigkeit zu einem Einjahreskatamnesezeitpunkt waren mit der ersten Hypothese konform, aber inkonsistent mit der zweiten. Eine systematische Untersuchung der 32 nach der Ausbildung behandelten Fälle legt nahe, dass die Mehrzahl der Therapeuten keine grundlegende Kompetenz in zeitlich limitierter dynamischer Psychotherapie erworben hatte. Cette éude explore les effets sur les résultats thérapeutiques de la formation des thérapeutes dans une thérapie brève, manualissée. Dans le cadre du projet Vanderbilt II, chacun des 16 thérapeutes (8 psychiatrs et 8 psychologues cliniciens) a traité deux patients adultes modérément perturbés, chacun par sa méthode habituelle de thérapie brève; ensuite ils ont reçu une formation d'une année dans une méthode manualisée de thérapie brève, la Psychothérapie Dynamique Limitée dans le Temps (TLDP); pour finir, ils ont appliqué la TLDP à de meilleurs résultats en général, et qu'une amélioration comparativement plus importante sera observée chez des patients habituellement considérés comme moins adaptés à une thérapie dynamique brè. Les résultats obtenus à la terminaison n'ont pu confirmer aucune de ces hypothèses. Des mesures de la dépendance interpersonnelle une année après étaient consistantes avec la première hypothèse, mais les données catamnestiques étaient inconsistantes avec la deuxième. Une revue systématique des 32 cas après formation a suggéré que la majorité des thérapeutes n'avait pas acquis une compétence de base en TLDP. Este estudio exploró la efectividad del entrenamiento de terapeutas en una terapia breve manualizada. Como parte del proyecto Vanderbilt II, dieciséis terapeutas (ocho psiquiatras y ocho psicólogos clínicos) trataron dos pacientes adultos mooderadamente perturbados con sus métodos habituales de tratamiento a corto plazo. Estos terapeutas recibieron luego un año de entrenamiento en terapia dinámica breve manualizada que se Ilamó Psicoterapia Dinámica de Tiempo limitado (TLDP). Finalmente, administraron esta TLDP a dos pacientes más. La hipótesis fue que el entrenamiento ilevaría, en general, a resultados mejores y que habría mayor mejoramiento en pacientes menos aptos para una terapia dinámica breve. Los resultados a la terminación no apoyaron ninguna de las dos hipótesis. Las mediciones de dependencia interpersonal al año de seguimiento resultaron consistentes con la primera hipótesis, mientras que los resultados de seguimiento fueron inconsistentes con la segunda. Una revisión sistemática de los treinta y dos casos luego del entrenamiento sugiere que la mayoría de los terapeutas no había l.

Phlebitis associated with peripheral intravenous catheters in adults admitted to hospital in the Western Brazilian Amazon.

PubMed

Enes, Sandra Maria Sampaio; Opitz, Simone Perufo; Faro, André Ricardo Maia da Costa de; Pedreira, Mavilde de Luz Gonçalves

2016-04-01

To identify the presence of phlebitis and the factors that influence the development of this complication in adult patients admitted to hospital in the western Brazilian Amazon. Exploratory study with a sample of 122 peripheral intravenous catheters inserted in 122 patients in a medical unit. Variables related to the patient and intravenous therapy were analyzed. For the analysis, we used chi-square tests of Pearson and Fisher exact test, with 5% significance level. Complication was the main reason for catheter removal (67.2%), phlebitis was the most frequent complication (31.1%). The mean duration of intravenous therapy use was 8.81 days in continuous and intermittent infusion (61.5%), in 20G catheter (39.3%), inserted in the dorsal hand vein arc (36.9 %), with mean time of usage of 68.4 hours. The type of infusion (p=0.044) and the presence of chronic disease (p=0.005) and infection (p=0.007) affected the development of phlebitis. There was a high frequency of phlebitis in the sample, being influenced by concomitant use of continuous and intermittent infusion of drugs and solutions, and more frequent in patients with chronic diseases and infection. Identificar a presença de flebite e os fatores que influenciam o desenvolvimento desta complicação em pacientes adultos internados em hospital da Amazônia Ocidental Brasileira. Estudo exploratório, com amostra de 122 cateteres intravenosos periféricos instalados em 122 pacientes de uma unidade de clínica médica. Foram analisadas variáveis relacionadas ao paciente e à terapia intravenosa. Para a análise utilizaram-se os testes de Qui-quadrado de Pearson e Exato de Fisher, com nível de significância de 5%. A complicação foi o principal motivo da retirada do cateter (67,2%), e a flebite a complicação mais frequente (31,1%). O tempo médio de uso de terapia intravenosa foi de 8,81 dias, em infusão contínua e intermitente (61,5%), em cateter calibre 20G (39,3%), inseridos nas veias do arco dorsal da mão (36,9%), com média de tempo de permanência de 68,4 horas. O tipo de infusão (p=0,044) e a presença de doença crônica (p=0,005) e de infecção (p=0,007) influenciaram o desenvolvimento de flebite. Houve alta frequência de flebite na amostra estudada, sendo influenciada pelo emprego concomitante de infusão contínua e intermitente de fármacos e soluções, e mais frequente em pacientes com doenças crônicas e infecção.

Use of 2-octyl cyanoacrylate adhesive in rat liver induced lesion.

PubMed

Santos, Orlando José dos; Marques, Giancarlo de Souza; Sauaia Filho, Euler Nicolau; Frota, Gustavo Medeiros; Santos, Rayan Haquim Pinheiro; Santos, Rennan Abud Pinheiro

2012-09-01

To evaluate the healing process of rat traumatic liver lesion corrected with the use of 2-octyl cyanoacrylate adhesive, compared to the use of biologically absorbable chromed catgut thread suture. Thirty mail adult rats were divided into two groups (15 per group) according to the used method for liver lesion correction as follows: adhesive group (AG), and catgut group (CG); each group being divided into three subsets of five animals (7th, 14th, and 21st day), respectively, according to post-surgery evaluation. All animals were submitted to homogeneous lesion applying synthetic bonding to AG and using chromed catgut suture to CG for lesion correction. Macroscopic and microscopic parameters of healing processes were evaluated. Both groups of animals showed excellent abdominal wall healing, with no evidence of infection, and no abdominal cavity peritonitis or abscess. The presence of adherence was observed in both groups with no statistically significant difference. As to macroscopic evaluation, there was statistically significant difference with respect to specific factors of clinical inflammation (ischemic inflammation and giant celular inflammatory reaction) between animals evaluated on the 10th day (ischemic necrosis and giant cellular inflammatory reaction) among animals evaluated on the 14th day (A14 versus C14). Applying 2-octyl-cyanoacrylate adhesive for correcting rat liver lesion does not change healing process when compared to the use of chromed catgut stitch.

Association of canalicular membrane enzymes with bile acid micelles and lipid aggregates in human and rat bile.

PubMed

Accatino, L; Pizarro, M; Solís, N; Koenig, C S

1995-01-18

This study was undertaken to gain insights into the characteristics of the polymolecular association between canalicular membrane enzymes, bile acids, cholesterol and phospholipids in bile and into the celular mechanisms whereby the enzymes are secreted into bile. With this purpose, we studied the distribution of bile acids, cholesterol, phospholipids, proteins and representative canalicular membrane enzymes (alkaline phosphatase, 5'-nucleotidase and gamma-glutamyl transpeptidase), which can be considered specific marker constituents, in bile fractions enriched in phospholipid-cholesterol lamellar structures (multilamellar and unilamellar vesicles) and bile acid-mixed micelles. These fractions were isolated by ultracentrifugation from human hepatic bile, normal rat bile and bile of rats treated with diosgenin, a steroid that induces a marked increase in biliary cholesterol secretion, and were characterized by density, lipid composition and transmission electron microscopy. These studies demonstrate that alkaline phosphatase, 5'-nucleotidase and gamma-glutamyl transpeptidase are secreted into both human and rat bile where they are preferentially associated with bile acid-mixed micelles, suggesting a role for bile acids in both release of these enzymes and lipids from the canalicular membrane and solubilization in bile. In addition, heterogeneous association of these enzymes with nonmicellar, lamellar structures in human and rat bile is consistent with the hypothesis that processes independent of the detergent effects of bile acids might also result in the release of specific intrinsic membrane proteins into bile.

[Superficial mycoses: comparative study between type 2 diabetic patients and a non-diabetic control group].

PubMed

García-Humbría, Leila; Richard-Yegres, Nicole; Pérez-Blanco, Maigualida; Yegres, Francisco; Mendoza, Mireya; Acosta, Arnaldo; Hernández, Rosaura; Zárraga, Eluz

2005-03-01

Superficial mycoses are considered to affect more frequently patients with type 2 diabetes mellitus (DM-2), specially onychomycosis and Tinea pedis. The purpose of this study was to compare the dermatophytoses, candidiasis and Pitiriasis versicolor frequency between 40 patients with DM-2 and 40 healthy persons of either sex, 40 years old or more. Clinical, metabolic, mycologic and inmunologic studies against Candida albicans, were carried out. Both diabetics 75% (30/40) and controls 65% (26/40) presented a high frequency of superficial mycoses (no significant difference p = 0.329). Pitiriasis versicolor was not detected in diabetic patients. They presented Tinea unguium, concomitant with Tinea pedis, with a higher frequency. The predominant dermatophyte was Trichophyton rubrum 18/23 (78%) in diabetics and 8/16 (50%) in non diabetics. Candida was isolated as commensal from oral mucous: 23/40 (58%) in diabetics and 21/40 (52%) in non diabetics (serotipo A was the more frequent), and from onychomycosis: 11/40 (28%) in diabetics and 12/40 (30%) in non diabetics. The immunological response was the same in both groups: celular 100%, humoral 20%. No statistical correlation among superficial mycoses, blood glucose level, glycosylated hemoglobin values or the time suffering the disease was observed. The high susceptibility to dermatophytes and Candida sp. infection showed to be associated with age and no with the diabetic type 2 condition in those patients.

A 62-MeV Proton Beam for the Treatment of Ocular Melanoma at Laboratori Nazionali del Sud-INFN

NASA Astrophysics Data System (ADS)

Cirrone, G. A. P.; Cuttone, G.; Lojacono, P. A.; Lo Nigro, S.; Mongelli, V.; Patti, I. V.; Privitera, G.; Raffaele, L.; Rifuggiato, D.; Sabini, M. G.; Salamone, V.; Spatola, C.; Valastro, L. M.

2004-06-01

At the Istituto Nazionale di Fisica Nucleare-Laboratori Nazionali del Sud (INFN-LNS) in Catania, Italy, the first Italian protontherapy facility, named Centro di AdroTerapia e Applicazioni Nucleari Avanzate (CATANA) has been built in collaboration with the University of Catania. It is based on the use of the 62-MeV proton beam delivered by the K=800 Superconducting Cyclotron installed and working at INFN-LNS since 1995. The facility is mainly devoted to the treatment of ocular diseases like uveal melanoma. A beam treatment line in air has been assembled together with a dedicated positioning patient system. The facility has been in operation since the beginning of 2002 and 66 patients have been successfully treated up to now. The main features of CATANA together with the clinical and dosimetric features will be extensively described; particularly, the proton beam line, that has been entirely built at LNS, with all its elements, the experimental transversal and depth dose distributions of the 62-MeV proton beam obtained for a final collimator of 25-mm diameter and the experimental depth dose distributions of a modulated proton beam obtained for the same final collimator. Finally, the clinical results over 1 yr of treatments, describing the features of the treated diseases will be reported.

Humidification and heating of inhaled gas in patients with artificial airway. A narrative review

PubMed Central

Plotnikow, Gustavo Adrián; Accoce, Matias; Navarro, Emiliano; Tiribelli, Norberto

2018-01-01

Instrumentation of the airways in critical patients (endotracheal tube or tracheostomy cannula) prevents them from performing their function of humidify and heating the inhaled gas. In addition, the administration of cold and dry medical gases and the high flows that patients experience during invasive and non-invasive mechanical ventilation generate an even worse condition. For this reason, a device for gas conditioning is needed, even in short-term treatments, to avoid potential damage to the structure and function of the respiratory epithelium. In the field of intensive therapy, the use of heat and moisture exchangers is common for this purpose, as is the use of active humidification systems. Acquiring knowledge about technical specifications and the advantages and disadvantages of each device is needed for proper use since the conditioning of inspired gases is a key intervention in patients with artificial airway and has become routine care. Incorrect selection or inappropriate configuration of a device can have a negative impact on clinical outcomes. The members of the Capítulo de Kinesiología Intensivista of the Sociedad Argentina de Terapia Intensiva conducted a narrative review aiming to show the available evidence regarding conditioning of inhaled gas in patients with artificial airways, going into detail on concepts related to the working principles of each one. PMID:29742220

Humidification and heating of inhaled gas in patients with artificial airway. A narrative review.

PubMed

Plotnikow, Gustavo Adrián; Accoce, Matias; Navarro, Emiliano; Tiribelli, Norberto

2018-03-01

Instrumentation of the airways in critical patients (endotracheal tube or tracheostomy cannula) prevents them from performing their function of humidify and heating the inhaled gas. In addition, the administration of cold and dry medical gases and the high flows that patients experience during invasive and non-invasive mechanical ventilation generate an even worse condition. For this reason, a device for gas conditioning is needed, even in short-term treatments, to avoid potential damage to the structure and function of the respiratory epithelium. In the field of intensive therapy, the use of heat and moisture exchangers is common for this purpose, as is the use of active humidification systems. Acquiring knowledge about technical specifications and the advantages and disadvantages of each device is needed for proper use since the conditioning of inspired gases is a key intervention in patients with artificial airway and has become routine care. Incorrect selection or inappropriate configuration of a device can have a negative impact on clinical outcomes. The members of the Capítulo de Kinesiología Intensivista of the Sociedad Argentina de Terapia Intensiva conducted a narrative review aiming to show the available evidence regarding conditioning of inhaled gas in patients with artificial airways, going into detail on concepts related to the working principles of each one.

TRANEXAMIC ACID ACTION ON LIVER REGENERATION AFTER PARTIAL HEPATECTOMY: EXPERIMENTAL MODEL IN RATS.

PubMed

Sobral, Felipe Antonio; Daga, Henrique; Rasera, Henrique Nogueira; Pinheiro, Matheus da Rocha; Cella, Igor Furlan; Morais, Igor Henrique; Marques, Luciana de Oliveira; Collaço, Luiz Martins

2016-01-01

Different lesions may affect the liver resulting in harmful stimuli. Some therapeutic procedures to treat those injuries depend on liver regeneration to increase functional capacity of this organ. Evaluate the effects of tranexamic acid on liver regeneration after partial hepatectomy in rats. 40 rats (Rattus norvegicus albinus, Rodentia mammalia) of Wistar-UP lineage were randomly divided into two groups named control (CT) and tranexamic acid (ATX), with 20 rats in each. Both groups were subdivided, according to liver regeneration time of 32 h or seven days after the rats had been operated. The organ regeneration was evaluated through weight and histology, stained with HE and PCNA. The average animal weight of ATX and CT 7 days groups before surgery were 411.2 g and 432.7 g, and 371.3 g and 392.9 g after the regeneration time, respectively. The average number of mitotic cells stained with HE for the ATX and CT 7 days groups were 33.7 and 32.6 mitosis, and 14.5 and 14.9 for the ATX and CT 32 h groups, respectively. When stained with proliferating cell nuclear antigen, the numbers of mitotic cells counted were 849.7 for the ATX 7 days, 301.8 for the CT 7 days groups, 814.2 for the ATX 32 hand 848.1 for the CT 32 h groups. Tranexamic acid was effective in liver regeneration, but in longer period after partial hepatectomy. Muitas são as injúrias que acometem o fígado e levam a estímulo lesivo. Alguns procedimentos terapêuticos para tratamento dessas lesões dependem da regeneração hepática para aumentar a sua capacidade funcional. Avaliar o efeito do ácido tranexâmico na regeneração hepática após hepatectomia parcial em ratos. Foram utilizados 40 ratos (Rattus norvegicus albinus, Rodentia mammalia) convencionais da linhagem Wistar-UP. Foram divididos aleatoriamente em dois grupos de 20: grupo controle (CT) e grupo ácido tranexâmico (ATX). Cada um deles foi divido em dois subgrupos para avaliar a regeneração hepática no tempo de 32 h e 7 dias do pós-operatório. A regeneração do órgão foi avaliada quanto ao peso e histologia, sendo esta última por hematoxilina-eosina e antígeno nuclear de proliferação celular. A média dos pesos dos animais dos grupos ATX 7 dias e CT 7 dias no pré-operatório foram de 411,2 g e 432,7 g, respectivamente, e após a regeneração foram de 371,3 g e 392,9 g. As médias das taxas de mitose coradas por HE dos dois grupos em 7 dias foram de 33,7 e 32,6 mitoses, respectivamente, e de 14,5 e 14,9 mitoses para os grupos ATX e CT 32 h. A contagem de células por antígeno nuclear de proliferação celular mostrou valores de 849,7 para o grupo ATX 7 dias e 301,8 para o CT 7 dias; 814,2 para o grupo ATX 32 h e 848,1 para o CT 32 h. O ácido tranexâmico mostrou-se efetivo na regeneração hepática somente em período mais longo de observação após hepatectomia parcial.

Economic analysis of costs with enteral and parenteral nutritional therapy according to disease and outcome.

PubMed

Hyeda, Adriano; Costa, Élide Sbardellotto Mariano da

2017-01-01

To conduct an economic analysis of enteral and parenteral diet costs according to the type of disease and outcome (survivors versus deaths). It is a cross-sectional, observational, retrospective study with a qualitative and quantitative design, based on analysis of hospital accounts from a healthcare insurance provider in the Southern region of Brazil. We analyzed 301 hospital accounts of individuals who used enteral and parenteral diets. The total cost of the diet was 35.4% of hospital account total costs. The enteral modality accounted for 59.8% of total dietary costs. The major costs with diets were observed in hospitalizations related to infections, cancers and cerebro-cardiovascular diseases. The major costs with parenteral diet were with admissions related by cancers (64.52%) and dementia syndromes (46.17%). The highest ratio between total diet costs with the total of hospital account costs was in dementia syndromes (46.32%) and in cancers (41.2%). The individuals who died spent 51.26% of total of hospital account costs, being 32.81% in diet (47.45% of total diet value and 58.81% in parenteral modality). Enteral and parenteral nutritional therapies account for a significant part of the costs with hospitalized individuals, especially in cases of cancers and dementia syndromes. The costs of parenteral diets were higher in the group of patients who died. Realizar uma análise econômica de custos da terapia nutricional enteral e parenteral, conforme o tipo de doença e o desfecho (sobreviventes versus óbitos). Estudo transversal, observacional, retrospectivo, com estratégia qualitativa e quantitativa, a partir da análise de contas hospitalares de uma operadora de saúde da Região Sul do Brasil. Foram analisadas 301 contas hospitalares de usuários que utilizaram dieta enteral e parenteral. O custo total com dieta foi de 35,4% do custo total das contas hospitalares. A modalidade enteral representou 59,8% do custo total em dieta. Os maiores custos com dieta foram observados em internações relacionadas a infecções, cânceres e doenças cérebro-cardiovasculares. Os maiores custos com dieta parenteral foram observados nas internações relacionadas aos cânceres (64,52%) e às síndromes demenciais (46,17%). A maior relação entre o custo total com dieta e o custo total da conta foi na síndrome demencial (46,32%) e no câncer (41,2%). Os usuários que foram a óbito consumiram 51,26% dos custos totais das contas, sendo 32,81% com dieta (47,45% do valor total com dieta e 58,81% do custo na modalidade parenteral). As terapias nutricionais enteral e parenteral representaram uma parte importante dos custos no tratamento de indivíduos hospitalizados, principalmente nos casos dos cânceres e nas síndromes demenciais. O custo com dieta parenteral foi maior no grupo de usuários que foram a óbito.

Adherence to immunosuppressive therapy following liver transplantation: an integrative review.

PubMed

Oliveira, Ramon Antônio; Turrini, Ruth Natália Teresa; Poveda, Vanessa de Brito

2016-08-29

to investigate the evidence available in the literature on non-adherence to immunosuppressive therapy among patients undergoing liver transplantation. integrative literature review, including research whose sample consisted of patients aged over 18 years undergoing liver transplantation. It excluded those containing patients undergoing multiple organ transplants. For the selection of articles, Medline / Pubmed, CINAHL, LILACS, Scopus and Embase were searched. The search period corresponded to the initial date of indexation of different bases, up to the deadline of February 10, 2015, using controlled and uncontrolled descriptors: liver transplantation, hepatic transplantation, liver orthotopic transplantation, medication adherence, medication non-adherence, medication compliance and patient compliance. were located 191 investigations, 10 of which met the objectives of the study and were grouped into four categories, namely: educational process and non-adherence; non-adherence related to the number of daily doses of immunosuppressive medications; detection methods for non-adherence and side effects of therapy. there were risk factors related to the health service, such as control and reduction of the number of doses; related to the individual, such as being male, divorced, alcohol or other substances user, exposed to low social support and being mentally ill. investigar as evidências disponíveis na literatura sobre a não adesão à terapêutica imunossupressora entre pacientes submetidos ao transplante de fígado. revisão integrativa da literatura, que incluiu investigações cuja amostra era composta por pacientes com idade igual ou superior a 18 anos, submetidos a transplante de fígado. Excluíram-se as que continham pacientes submetidos a transplantes de múltiplos órgãos. Para a seleção dos artigos foram consultadas as bases Medline/Pubmed, CINAHL, LILACS, Scopus e Embase. O período de busca determinado correspondeu à data inicial de indexação das diferentes bases, até a data limite de 10 de fevereiro de 2015, empregando-se os descritores controlados e não controlados: liver transplantation, hepatic transplantation, liver orthotopic transplantation, medication adherence, medication non-adherence, medication compliance e patient compliance. foram localizadas 191 investigações, das quais 10 atenderam aos objetivos do estudo e foram agrupadas em quatro categorias, a saber: processo educativo e ocorrência de não adesão; não adesão relacionada ao número de doses diárias dos medicamentos imunossupressores; métodos de detecção da não adesão e efeitos colaterais da terapêutica. verificou-se a existência de fatores de risco relacionados ao serviço de saúde, como controle e redução do número de doses; relacionados ao indivíduo, como ser do sexo masculino, divorciado, usuário de álcool ou outras substâncias, expostos a menor suporte social e portadores de transtorno mental. investigar la evidencia disponible en la literatura sobre la falta de adherencia a la terapia inmunosupresora en los pacientes sometidos a trasplante hepático. revisión integradora de la literatura, que incluye investigaciones cuya muestra estaba constituida por pacientes mayores de 18 años sometidos a trasplante hepático. Se excluyeron aquellos que tenían pacientes sometidos a trasplantes de varios órganos. Para la selección de los artículos fueron consultadas las bases Medline / Pubmed, CINAHL, LILACS, Scopus y Embase. El período de búsqueda determinado correspondió a la fecha inicial de indexación de las diferentes bases, con fecha límite de 10 de febrero de 2015, usándose descriptores controlados y no controlados: liver transplantation, hepatic transplantation, liver orthotopic transplantation, medication adherence, medication non-adherence, medication compliance e patient compliance. se localizaron 191 investigaciones, de los cuales 10 cumplieron con los objetivos del estudio y se agruparon en cuatro categorías, a saber: proceso educativo y ocurrencia de no adhesión; falta de adhesión relacionada con el número de dosis diarias de medicamentos inmunosupresores; métodos de detección de la falta de adhesión y los efectos secundarios de la terapia. se verificaron factores de riesgo relacionados con el servicio de salud, tales como el control y la reducción del número de dosis; inherentes a la persona, como ser hombre, divorciado, usuario de alcohol u otras sustancias, expuestos a un menor apoyo social y portadores de enfermedades mentales.

Lead tolerance in plants: strategies for phytoremediation.

PubMed

Gupta, D K; Huang, H G; Corpas, F J

2013-04-01

Lead (Pb) is naturally occurring element whose distribution in the environment occurs because of its extensive use in paints, petrol, explosives, sludge, and industrial wastes. In plants, Pb uptake and translocation occurs, causing toxic effects resulting in decrease of biomass production. Commonly plants may prevent the toxic effect of heavy metals by induction of various celular mechanisms such as adsorption to the cell wall, compartmentation in vacuoles, enhancement of the active efflux, or induction of higher levels of metal chelates like a protein complex (metallothioneins and phytochelatins), organic (citrates), and inorganic (sulphides) complexes. Phyotochelains (PC) are synthesized from glutathione (GSH) and such synthesis is due to transpeptidation of γ-glutamyl cysteinyl dipeptides from GSH by the action of a constitutively present enzyme, PC synthase. Phytochelatin binds to Pb ions leading to sequestration of Pb ions in plants and thus serves as an important component of the detoxification mechanism in plants. At cellular level, Pb induces accumulation of reactive oxygen species (ROS), as a result of imbalanced ROS production and ROS scavenging processes by imposing oxidative stress. ROS include superoxide radical (O2(.-)), hydrogen peroxide (H2O2) and hydroxyl radical ((·)OH), which are necessary for the correct functioning of plants; however, in excess they caused damage to biomolecules, such as membrane lipids, proteins, and nucleic acids among others. To limit the detrimental impact of Pb, efficient strategies like phytoremediation are required. In this review, it will discuss recent advancement and potential application of plants for lead removal from the environment.

Prone position in patients with acute respiratory distress syndrome

PubMed Central

Setten, Mariano; Plotnikow, Gustavo Adrián; Accoce, Matías

2016-01-01

Acute respiratory distress syndrome occupies a great deal of attention in intensive care units. Despite ample knowledge of the physiopathology of this syndrome, the focus in intensive care units consists mostly of life-supporting treatment and avoidance of the side effects of invasive treatments. Although great advances in mechanical ventilation have occurred in the past 20 years, with a significant impact on mortality, the incidence continues to be high. Patients with acute respiratory distress syndrome, especially the most severe cases, often present with refractory hypoxemia due to shunt, which can require additional treatments beyond mechanical ventilation, among which is mechanical ventilation in the prone position. This method, first recommended to improve oxygenation in 1974, can be easily implemented in any intensive care unit with trained personnel. Prone position has extremely robust bibliographic support. Various randomized clinical studies have demonstrated the effect of prone decubitus on the oxygenation of patients with acute respiratory distress syndrome measured in terms of the PaO2/FiO2 ratio, including its effects on increasing patient survival. The members of the Respiratory Therapists Committee of the Sociedad Argentina de Terapia Intensiva performed a narrative review with the objective of discovering the available evidence related to the implementation of prone position, changes produced in the respiratory system due to the application of this maneuver, and its impact on mortality. Finally, guidelines are suggested for decision-making. PMID:27925054

Measurement of neutron spectra generated by a 62 AMeV carbon-ion beam on a PMMA phantom using extended range Bonner sphere spectrometers

NASA Astrophysics Data System (ADS)

Bedogni, R.; Amgarou, K.; Domingo, C.; Russo, S.; Cirrone, G. A. P.; Pelliccioni, M.; Esposito, A.; Pola, A.; Introini, M. V.; Gentile, A.

2012-07-01

Neutrons constitute an important component of the radiation environment in hadron therapy accelerators. Their energy distribution may span from thermal up to hundred of MeV. The characterization of these fields in terms of dosimetric or spectrometric quantities is crucial for either the patient protection or the facility design aspects. To date, the Extended Range Bonner Sphere Spectrometer (ERBSS) is the only instrument able to simultaneously determine all spectral components in such workplaces. With the aim of providing useful data to the scientific community involved in neutron measurements at hadron therapy facilities, a measurement campaign was carried out at the Centro di AdroTerapia e Applicazioni Nucleari Avanzate (CATANA) of INFN-LNS (Laboratori Nazionali del Sud), where a 62 AMeV carbon ion is available. The beam was directed towards a PMMA phantom, simulating the patient, and two neutron measurement points were established at 0° and 90° with respect to the beam-line. The ERBSSs of UAB (Universidad Autónoma de Barcelona-Grup de Física de les Radiacions) and INFN (Istituto Nazionale di Fisica Nucleare-Laboratori Nazionali di Frascati) were used to measure the resulting neutron fields. The two ERBSSs use different detectors and sphere diameters, and have been independently calibrated. The FRUIT code was used to unfold the results.

Marketing research on the angiotensin-converting enzyme inhibitors antihypertensive medicines.

PubMed

Boboia, Anamaria; Grigorescu, Marius Rareş; Turcu-Ştiolică, Adina

2017-01-01

The research aimed at investigating sales trends of angiotensin-converting enzyme inhibitors antihypertensive medicines, both in terms of quantity and value, in ten community pharmacies, for a period of three years. The research on the antihypertensive medicines consumption is important for highlighting the ever increasing impact of hypertension among the population. The methods used in this research were the following: marketing research, method of sampling, descriptive methods, retrospective analysis, method of comparison. The results showed that the drugs containing the active substances of the angiotensin converting enzyme inhibitors class had had significant increases in quantitative and value sales, bringing substantial revenues to pharmacies. From the quantitative perspective, the best-selling products were those containing Enalaprilum, while in terms of value, the best-selling medicines were those containing Perindoprilum. We evidenced that spectacular sales were also achieved for products that have Lisinoprilum, respectively Captoprilum, as active substances. The largest quantities were marketed for the Captopril Terapia® product and the highest earnings were recorded for the Prestarium® medicine. This paper approaches an interesting and topical issue, which can be helpful to professionals (pharmacists, doctors) and other categories, such as economists, statisticians, representatives of companies manufacturing medicines, as well as to hypertensive patients, as it could be used to warn population regarding the incidence of cardiovascular diseases, and, at the same time, trace sales trends in order to accomplish profitable business plans.

Resistencia a antibióticos de última línea en cocos Gram positivos: la era posterior a la vancomicina

PubMed Central

Rincón, Sandra; Panesso, Diana; Díaz, Lorena; Carvajal, Lina P.; Reyes, Jinnethe; Munita, José M.; Arias, César A.

2015-01-01

En los últimos años se han desarrollado nuevas alternativas para el tratamiento de infecciones por patógenos Gram positivos multirresistentes, entre los cuales Staphylococcus aureus resistente a la meticilina (SARM) y los enterococos resistentes a la vancomicina (ERV) se consideran un verdadero reto terapéutico, y aunque el uso de la vancomicina en infecciones graves causadas por SARM ha generado serias dudas en los últimos años, continúa siendo escasa la información clínica de respaldo al uso de agentes terapéuticos que la superen en eficacia. El linezolid, la daptomicina y la tigeciclina son agentes que tienen actividad contra los cocos Gram positivos y que fueron aprobados e introducidos en la terapia clínica en la década pasada. Además, se han probado o están en las fases finales de desarrollo otros agentes como las cefalosporinas de última generación (ceftarolina y ceftobiprol). El propósito de esta revisión fue describir las nuevas alternativas terapéuticas, particularmente en la era posterior a la vancomicina, y repasar las características químicas más relevantes de los compuestos y su espectro de actividad, haciendo énfasis en sus mecanismos de acción y resistencia. PMID:24968051

Trombose induzida pelo calor endovenoso: relato de dois casos tratados com rivaroxabana e revisão da literatura

PubMed Central

de Araujo, Walter Junior Boim; Timi, Jorge Rufino Ribas; Erzinger, Fabiano Luiz; Caron, Filipe Carlos

2016-01-01

Resumo Define-se trombose induzida pelo calor endovenoso como a propagação do trombo a partir de uma veia superficial em direção a uma veia mais profunda. Em geral, é considerada clinicamente insignificante quando não há propagação do trombo para o sistema venoso profundo. Essa condição pode ser tratada com terapia anticoagulante, embora a observação pareça ser suficiente, principalmente para graus menores. Neste estudo, relatamos dois casos de trombose induzida pelo calor endovenoso que teriam indicação de heparina de baixo peso molecular até a resolução do quadro. Porém, optou-se pelo uso da rivaroxabana (15 mg de 12 em 12h), com resolução completa do trombo em 4 semanas (caso 1) e em 7 dias (caso 2). A rivaroxabana pode ser uma alternativa promissora no tratamento da trombose induzida pelo calor endovenoso avançada, pela simplicidade da posologia, sem comprometimento da eficácia ou da segurança. São necessários estudos prospectivos, randomizados e controlados que possibilitem melhor entendimento da condição e o desenvolvimento de recomendações mais definitivas sobre opções de prevenção e tratamento.

Impact of respiratory therapy in vital capacity and functionality of patients undergoing abdominal surgery.

PubMed

Fernandes, Shanlley Cristina da Silva; Santos, Rafaella Souza Dos; Giovanetti, Erica Albanez; Taniguchi, Corinne; Silva, Cilene Saghabi de Medeiros; Eid, Raquel Afonso Caserta; Timenetsky, Karina Tavares; Carnieli-Cazati, Denise

2016-01-01

To evaluate the vital capacity after two chest therapy techniques in patients undergoing abdominal surgical. A prospective randomized study carried out with patients admitted to the Intensive Care Unit after abdominal surgery. We checked vital capacity, muscular strength using the Medical Research Council scale, and functionality with the Functional Independence Measure the first time the patient was breathing spontaneously (D1), and also upon discharge from the Intensive Care Unit (Ddis). Between D1 and Ddis, respiratory therapy was carried out according to the randomized group. We included 38 patients, 20 randomized to Positive Intermittent Pressure Group and 18 to Volumetric Incentive Spirometer Group. There was no significant gain related to vital capacity of D1 and Ddis of Positive Intermittent Pressure Group (mean 1,410mL±547.2 versus 1,809mL±692.3; p=0.979), as in the Volumetric Incentive Spirometer Group (1,408.3mL±419.1 versus 1,838.8mL±621.3; p=0.889). We observed a significant improvement in vital capacity in D1 (p<0.001) and Ddis (p<0.001) and in the Functional Independence Measure (p<0.001) after respiratory therapy. The vital capacity improvement was not associated with gain of muscle strength. Chest therapy, with positive pressure and volumetric incentive spirometer, was effective in improving vital capacity of patients submitted to abdominal surgery. Avaliar a capacidade vital comparando duas técnicas de fisioterapia respiratória em pacientes submetidos à cirurgia abdominal. Estudo prospectivo e randomizado realizado com pacientes admitidos em Unidade de Terapia Intensiva após cirurgia abdominal. Verificamos a capacidade vital, a força muscular por meio da escala do Medical Research Council e funcionalidade pela Medida de Independência Funcional no primeiro momento em que o paciente encontrava-se em respiração espontânea (D1) e na alta da Unidade de Terapia Intensiva (Dalta). Entre D1 e Dalta, foi realizada a fisioterapia respiratória, conforme o grupo randomizado. Foram incluídos 38 pacientes, sendo 20 randomizados para Grupo Pressão Positiva Intermitente e 18 para o Grupo Incentivador Inspiratório a Volume. A capacidade vital entre o D1 e Dalta do Grupo Pressão Positiva Intermitente não teve ganho significativo (média de 1.410mL±547,2 versus 1.809mL±692,3; p=0,979), assim como no Grupo Incentivador Inspiratório a Volume (1.408,3mL±419,1 versus 1.838,8mL±621,3; p=0,889). Houve melhora significativa da capacidade vital no D1 (p<0,001) e na Dalta (p<0,001) e da Medida de Independência Funcional (p<0,001) após a fisioterapia respiratória. A melhora da capacidade vital não apresentou relação com o ganho da força muscular. A fisioterapia respiratória, por meio de pressão positiva ou de incentivador inspiratório a volume, foi eficaz na melhora da capacidade vital em pacientes submetidos à cirurgia abdominal.

Impact of critical care environment on burnout, perceived quality of care and safety attitude of the nursing team.

PubMed

Guirardello, Edinêis de Brito

2017-06-05

assess the perception of the nursing team about the environment of practice in critical care services and its relation with the safety attitude, perceived quality of care and burnout level. cross-sectional study involving 114 nursing professionals from the intensive care unit of a teaching hospital. The following instruments were used: Nursing Work Index-Revised, Maslach Burnout Inventory and the Safety Attitude Questionnaire. the professionals who perceived greater autonomy, good relationships with the medical team and better control over the work environment presented lower levels of burnout, assessed the quality of care as good and reported a positive perception on the safety attitude for the domain job satisfaction. the findings evidenced that environments favorable to these professionals' practice result in lower levels of burnout, a better perceived quality of care and attitudes favorable to patient safety. avaliar a percepção da equipe de enfermagem sobre o ambiente da prática em unidades de cuidados críticos e sua relação com atitude de segurança, percepção da qualidade do cuidado e nível de burnout. estudo transversal com a participação de 114 profissionais de enfermagem da unidade de terapia intensiva de um hospital de ensino. Foram utilizados os instrumentos: Nursing Work Index-Revised, Inventário de Burnout de Maslach e o Questionário de Atitudes de Segurança. os profissionais que perceberam maior autonomia, boas relações com a equipe médica e melhor controle sobre o ambiente de trabalho, apresentaram menores níveis de burnout, avaliaram como boa a qualidade do cuidado e relataram uma percepção positiva da atitude de segurança para o domínio satisfação no trabalho. os achados evidenciaram que ambientes favoráveis à prática desses profissionais resultam em menores níveis de burnout, melhor percepção da qualidade do cuidado e atitudes favoráveis à segurança do paciente. evaluar la percepción del equipo de enfermería sobre el ambiente de la práctica en unidades de cuidados críticos y su relación con actitud de seguridad, percepción de la calidad del cuidado y nivel de burnout. estudio trasversal con la participación de 114 profesionales de enfermería de la unidad de terapia intensiva de un hospital de enseñanza. Fueron utilizados los instrumentos: Nursing Work Index-Revised, Inventario de Burnout de Maslach y el Cuestionario de Actitudes de Seguridad. los profesionales que percibieron mayor autonomía, buenas relaciones con el equipo médico y mejor control sobre el ambiente de trabajo presentaron menores niveles de burnout, evaluaron como buena la calidad del cuidado y relataron percepción positiva de la actitud de seguridad para el dominio satisfacción en el trabajo. los hallazgos evidenciaron que ambientes favorables a la práctica de esos profesionales resultan en menores niveles de burnout, mejor percepción de la calidad del cuidado y actitudes favorables a la seguridad del paciente.

Pressure ulcer dressings in critical patients: a cost analysis.

PubMed

Silva, Dinara Raquel Araújo; Bezerra, Sandra Marina Gonçalves; Costa, Jéssica Pereira; Luz, Maria Helena Barros Araújo; Lopes, Vanessa Caminha Aguiar; Nogueira, Lidya Tolstenko

2017-06-12

To assess the direct cost of dressings in pressure ulcer treatment. This was a descriptive observational study conducted at an intensive care unit in the Northeast region of Brazil, between November and December 2015. Data were gathered using the Pressure Ulcer Scale for Healing and a form to characterize and assess costs. Values in Brazilian reais (BRL) were converted into U.S. dollars at the exchange rate of USD 0.26/BRL. Univariate and bivariate analyses were conducted. The sample consisted of 15 patients with at least stage 2 ulcers. There was a significant reduction in costs with dressing materials between the initial and final assessments (p=0.002), with a mean of USD 11.9 (±7.4). The most common topical treatments used were essential fatty acids and papain. Cost reduction was proportional to the stage of pressure ulcer. The role of nurses in creating evidence-based care plans is crucial to improve care management. Avaliar o custo direto com curativos no tratamento de lesões por pressão. Estudo observacional descritivo, realizado em Unidade de Terapia Intensiva do nordeste do Brasil, de novembro a dezembro de 2015. Foi aplicada a Pressure Ulcer Scale for Healing e formulário para caracterização e avaliação de custos. Os valores da moeda brasileira (R$) foram convertidos para a moeda norte-americana (US$) à taxa de US$0,26/R$. Foram realizadas análises univariadas e bivariadas. Compuseram a amostra 15 pacientes com lesões, no mínimo, estágio 2. Houve redução significativa dos custos com materiais de curativos entre as avaliações inicial e final (p=0,002), com média de US$11,9 (±7,4). As terapias tópicas mais frequentes foram ácidos graxos essenciais e papaína. Verificou-se redução de custos proporcional aos estágios das lesões. Enfatiza-se o papel do enfermeiro na elaboração de planos de cuidados baseados em evidências para melhor gerenciamento do cuidado. Evaluar el costo directo de curativos para el tratamiento de lesiones por presión. Estudio observacional descriptivo en la Unidad de Cuidados Intensivos del noreste de Brasil, de noviembre a diciembre del año 2015. Se aplicó la Pressure Ulcer Scale for Healing y formulario para la caracterización y evaluación de los costos. Los valores de la moneda brasileña (Reales- R$) se convirtieron al dólar estadounidense (US$) a razón de $0.26/R$. Se realizaron análisis univariados y bivariados. La muestra consistió en 15 pacientes con lesiones al menos en Etapa 2. Hubo una reducción significativa en el costo de los materiales de curación entre las evaluaciones inicial y final (p=0,002), con un promedio de US$11.9 (±7.4). Los tratamientos tópicos más comunes son los ácidos grasos esenciales y papaína. Se verificó una reducción de los costos proporcional a las etapas de las lesiones. Se hace hincapié en el papel de los enfermeros en el desarrollo de planes de cuidados basados en la evidencia, para una mejor gestión de la atención.

Isolation of poxvirus from debilitating cutaneous lesions on four immature grackles (Quiscalus sp.)

USGS Publications Warehouse

Docherty, D.E.; Long, R.I.R.; Flickinger, Edward L.; Locke, L.N.

1991-01-01

Poxvirus was isolated from nodules on four immature grackles (Quiscalus sp.) collected in two residential areas of Victoria, Texas. All of the birds were emaciated and had nodules on the eyelids, bill, legs, toes, and areas of the skin on the wings, neck, and ventral abdomen. These pox nodules were extensive and probably interfered with both sight and flight. The preliminary diagnosis was confirmed by virus isolation, histopathology, and electron microscopy. Poxvirus was isolated on the chorioallantoic membrane of embryonated hen's eggs and in Muscovy duck embryo fibroblast cell culture. Phaenicia calliphoridae (blowfly) larvae were found in one of the pox nodules, raising the possibility of mechanical transmission of the virus by contaminated adult blowfiles. /// Se aisl?? virus de viruela a partir de n??dulos presentes en cuatro estorninos inmaduros (Quiscalus sp.) capturados en dos ?!reas residenciales de Victoria, Texas. Las cuatro aves estaban emaciadas y presentaron n??dulos en los p?!rpados, pico, patas, dedos, y algunas ?!reas de la piel de las alas, cuello, y regi??n inferior del abdomen. Estos n??dulos producidos por viruela eran extensos y probablemente interfirieron con la visi??n y el vuelo. El diagn??stico presuntivo fue confirmado mediante aislamiento viral, histopatolog?-a, y microscop?-a electr??nica. Se aisl?? el virus de viruela en la membrana corioalantoidea de huevos embrionados de gallina y en cultivos celulares de fibroblasto de embri??n de pato. Se encontraron larvas de mosca azul (Phaenicia calliphoridae) en uno de los n??dulos de viruela, increment?!ndose as?- la posibilidad de transmisi??n mec?!nica del virus mediante moscas adultas contaminadas.

Marketing research on the angiotensin-converting enzyme inhibitors antihypertensive medicines

PubMed Central

BOBOIA, ANAMARIA; GRIGORESCU, MARIUS RAREŞ; TURCU - ŞTIOLICĂ, ADINA

2017-01-01

Background and aims The research aimed at investigating sales trends of angiotensin-converting enzyme inhibitors antihypertensive medicines, both in terms of quantity and value, in ten community pharmacies, for a period of three years. The research on the antihypertensive medicines consumption is important for highlighting the ever increasing impact of hypertension among the population. Methods The methods used in this research were the following: marketing research, method of sampling, descriptive methods, retrospective analysis, method of comparison. Results The results showed that the drugs containing the active substances of the angiotensin converting enzyme inhibitors class had had significant increases in quantitative and value sales, bringing substantial revenues to pharmacies. From the quantitative perspective, the best-selling products were those containing Enalaprilum, while in terms of value, the best-selling medicines were those containing Perindoprilum. We evidenced that spectacular sales were also achieved for products that have Lisinoprilum, respectively Captoprilum, as active substances. The largest quantities were marketed for the Captopril Terapia® product and the highest earnings were recorded for the Prestarium® medicine. Conclusion This paper approaches an interesting and topical issue, which can be helpful to professionals (pharmacists, doctors) and other categories, such as economists, statisticians, representatives of companies manufacturing medicines, as well as to hypertensive patients, as it could be used to warn population regarding the incidence of cardiovascular diseases, and, at the same time, trace sales trends in order to accomplish profitable business plans. PMID:28246502

Benefits and risks of testosterone treatment for hypoactive sexual desire disorder in women: a critical review of studies published in the decades preceding and succeeding the advent of phosphodiesterase type 5 inhibitors

PubMed Central

Reis, Sandra Léa Bonfim; Abdo, Carmita H. N.

2014-01-01

With advancing age, there is an increase in the complaints of a lack of a libido in women and erectile dysfunction in men. The efficacy of phosphodiesterase type 5 inhibitors, together with their minimal side effects and ease of administration, revolutionized the treatment of erectile dysfunction. For women, testosterone administration is the principal treatment for hypoactive sexual desire disorder. We sought to evaluate the use of androgens in the treatment of a lack of libido in women, comparing two periods, i.e., before and after the advent of the phosphodiesterase type 5 inhibitors. We also analyzed the risks and benefits of androgen administration. We searched the Latin-American and Caribbean Health Sciences Literature, Cochrane Library, Excerpta Medica, Scientific Electronic Library Online, and Medline (PubMed) databases using the search terms disfunção sexual feminina/female sexual dysfunction, desejo sexual hipoativo/female hypoactive sexual desire disorder, testosterona/testosterone, terapia androgênica em mulheres/androgen therapy in women, and sexualidade/sexuality as well as combinations thereof. We selected articles written in English, Portuguese, or Spanish. After the advent of phosphodiesterase type 5 inhibitors, there was a significant increase in the number of studies aimed at evaluating the use of testosterone in women with hypoactive sexual desire disorder. However, the risks and benefits of testosterone administration have yet to be clarified. PMID:24714838

Identification of duck plague virus by polymerase chain reaction

USGS Publications Warehouse

Hansen, W.R.; Brown, Sean E.; Nashold, S.W.; Knudson, D.L.

1999-01-01

A polymerase chain reaction (PCR) assay was developed for detecting duck plague virus. A 765-bp EcoRI fragment cloned from the genome of the duck plague vaccine (DP-VAC) virus was sequenced for PCR primer development. The fragment sequence was found by GenBank alignment searches to be similar to the 3a?? ends of an undefined open reading frame and the gene for DNA polymerase protein in other herpesviruses. Three of four primer sets were found to be specific for the DP-VAC virus and 100% (7/7) of field isolates but did not amplify DNA from inclusion body disease of cranes virus. The specificity of one primer set was tested with genome templates from other avian herpesviruses, including those from a golden eagle, bald eagle, great horned owl, snowy owl, peregrine falcon, prairie falcon, pigeon, psittacine, and chicken (infectious laryngotracheitis), but amplicons were not produced. Hence, this PCR test is highly specific for duck plague virus DNA. Two primer sets were able to detect 1 fg of DNA from the duck plague vaccine strain, equivalent to five genome copies. In addition, the ratio of tissue culture infectious doses to genome copies of duck plague vaccine virus from infected duck embryo cells was determined to be 1:100, making the PCR assay 20 times more sensitive than tissue culture for detecting duck plague virus. The speed, sensitivity, and specificity of this PCR provide a greatly improved diagnostic and research tool for studying the epizootiology of duck plague. /// Se desarroll?? una prueba de reacci??n en cadena por la polimerasa para detectar el virus de la peste del pato. Un fragmento EcoRI de 765 pares de bases clonado del genoma del virus vacunal de la peste del pato fue secuenciado para la obtenci??n de los iniciadores de la prueba de la reacci??n en cadena por la polimerasa. En investigaciones de alineaci??n en el banco de genes ('GenBank') se encontr?? que la secuencia del fragmento era similar a los extremos 3a?? de un marco de lectura abierto indefinido y al gen para la proteina de la DNA polimerasa en otros virus herpes. Se encontraron tres o cuatro grupos de iniciadores especificos para el virus vacunal y para el 100% (7/7) de los a??slamientos de campo, pero no amplificaron el DNA del virus de hepatitis por cuerpos de inclusi??n de grullas. Se analiz?? la especificidad de un primer juego de iniciadores con moldes del genoma de otros virus herpes aviares, incluyendo el ?!guila dorada, ?!guila de cabeza blanca, lechuza de cuernos grandes, lechuza blanca, halc??n peregrino, palomas, aves psit?!cidas y pollos (virus de laringotraqueitis infecciosa), pero no se produjeron los productos finales. Por lo tanto, esta prueba de reacci??n en cadena por la polimerasa es altamente especifica para el DNA del virus. Dos grupos de iniciadores fueron capaces de detectar un fragmento de DNA de la cepa vacunal equivalente a cinco copias del genoma. Adem?!s, se determin?? que la proporci??n de la dosis infecciosa en cultivo celular y copias del genoma del virus vacunal de c??lulas de embri??n de pato infectadas era de 10 a 100 respectivamente, haciendo la prueba de la reacci??n en cadena por la polimerasa 20 veces m?!s sensible que el cultivo celular para detectar el virus. La velocidad, sensibilidad y especificidad de la prueba de la reacci??n en cadena por la polimerasa suministra una herramienta de investigaci??n y de diagn??stico altamente mejorada para el estudio de la epizootiolog?-a del virus.

MCP-1 in urine as biomarker of disease activity in Systemic Lupus Erythematosus.

PubMed

Barbado, Julia; Martin, Debora; Vega, Luisa; Almansa, Raquel; Gonçalves, Lisbeth; Nocito, Mercedes; Jimeno, Antonio; Ortiz de Lejarazu, Raúl; Bermejo-Martin, Jesus F

2012-11-01

Conventional clinical parameters are not sensitive or specific enough for detecting ongoing disease activity in the Systemic Lupus Erythematosus (SLE). Measurement of cytokines in urine is an encouraging approach to detection of early flares in this disease. Here we have profiled 27 different cytokines, chemokines and celular growth factors in the urine of 48 patients previously diagnosed of SLE as potential biomarkers of disease activity. Correlation analysis with Bonferroni correction showed that MCP-1 was the only immune mediator which levels in urine correlated directly with the SLE Disease Activity Index 2000 (SLEDAI-2K) score (correlation coefficient, p): MCP-1 (0.45,0.003). MCP-1 correlated inversely with levels of C3 complement protein in serum (-0.50,0.001). MCP-1 showed significant higher levels in patients with severe disease activity in comparison with those exhibiting mild activity. Levels of this chemokine were also higher in patients with severe disease activity in comparison with patients with inactive disease and healthy controls. Areas under receiver operating characteristic curves (AUROC) for detection of severe disease (SLEDAI⩾8) was as follows for MCP-1: [AUROC, (IC95%), p]: [0.81 (0.65-0.96) 0.003]. In addition, MCP-1 showed a good result in the AUROC analysis for detecting renal involvement [0.70 (0.52-0.87) 0.050]. When correlation analysis were repeated excluding those patients with active renal disease (n=14), levels of MCP-1 in urine kept on showing a significant positive association with SLEDAI-2K score. In conclusion, multiplex-based cytokine profiling in urine demonstrated the superiority of MCP-1 over a wide range of cytokines as biomarker of disease activity in SLE. Copyright © 2012 Elsevier Ltd. All rights reserved.

Coronary Allograft Vasculopathy after Cardiac Transplantation: Prevalence, Prognostic and Risk Factors.

PubMed

Antunes, André; Prieto, David; Pinto, Carlos; Branco, Carlos; Correia, Pedro; Batista, Manuel; Antunes, Manuel

2017-01-01

Coronary allograft vasculopathy (CAV) is still a serious long-term complication after cardiac transplantation. To evaluate the prevalence of CAV in a single institution, its impact on survival and to explore associated risk factors. From November-2003 through June-2016, 316 patients were submitted to cardiac transplantation. After excluding those with paediatric age (n=8), those with previous renal or hepatic transplantation (n=2) and those who didn't survive the first year after cardiac transplantation (n=40), the study population resulted in 266 patients. Forty two patients (15.8%) with CAV, diagnosed by a new >50% coronary artery stenosis in any vessel during follow-up, were compared with a non-CAV group. Both groups share de same median age (54+10years). Recipient male sex predominated in the CAV group (93% vs. 74%), as did ischemic etiology (52% vs. 37%). Although not reaching statistical significance, CAV patients also had more dyslipidemia (60% vs. 50%), history of smoking (52% vs. 44%) and peripheral vascular disease (45% vs. 29%). The incidence of celular acute rejection 1R is more frequent in CAV group (69% vs. 60%) such as 2R or 3R (29% vs. 27%). Prolonged use of inotropic support and mechanical assistance after cardiac transplantation were comparable between both groups. The survival of this patients, who were submitted to cardiac transplantation and had lived at least 1 year, between CAV and non-CAV group was comparable at 5-year (91% vs. 85%), but tended to be lower for CAV patients in 10-year interval (52% vs. 73%). This data confirms CAV as a common long-term complication following cardiac transplantation. Although short to mid-term survival seems not to be affected by CAV, long-term survival appears lower, hence a longer follow-up is needed.

Antifibrotic Mechanism of Pinocembrin: Impact on Oxidative Stress, Inflammation and TGF-β /Smad Inhibition in Rats.

PubMed

Said, Marwa M; Azab, Samar S; Saeed, Noha M; El-Demerdash, Ebtehal

2018-03-01

The present study aimed to elucidate the potential antifibrotic effects of pinocembrin (PIN), a flavanone found abundantly in honey and propolis, by studying its effect on different oxidative stress, inflammatory and fibrosis markers in an experimental model of CCl4-induced liver fibrosis. PIN (20 mg/kg) was given orally 3 times/week for 6 consecutive weeks alternating with CCl4 (0.5 mL/kg, 1:1 mixture with corn oil, i. p.) twice weekly. Different hepatotoxicity indices, oxidative stress, inflammatory and liver fibrosis markers were assessed. PIN significantly restored liver transaminases and total cholesterol to normal levels. Also, PIN ameliorated oxidative stress injury evoked by CCl4 as evidenced by inhibition of reduced glutathione depletion and lipid peroxidation as well as elevation of antioxidant enzyme superoxide dismutase (SOD). Further, PIN upregulated the nuclear factor erythroid 2 (NF-E2)-related factor 2 (Nrf2), thereby inducing the expression and activity of the cytoprotective enzyme hemeoxygenase-1 (HO-1). Moreover, PIN alleviated pro-inflammatory cytokines such as TNF-α via inhibiting nuclear factor-κB (NF-κB) activation. As markers of fibrosis, collagen and α-SMA expression increased markedly in the CCl4 group and PIN prevented these alterations. In addition, PIN down-regulated TGFβ1 and p-Smad2/3, thereby inhibiting TGFβ1/Smad signaling pathway. These results suggest that PIN possess potent antifibrotic effects that can be explained on its antioxidant properties. It ameliorates oxidative stress and inflammation during induction of fibrogenesis via its ability to augment celular antioxidant defenses, activating Nrf2-mediated HO-1 expression and modulating NF-κB and TGF-β1/Smad signaling pathway.

Contribuciones tecnicas para la medida de la contaminacion electromagnetica de microondas. Estudio en diversas poblaciones

NASA Astrophysics Data System (ADS)

Segura Garcia, Jaume

La contaminacion ambiental por campos electromagneticos ha resultado ser en estos ultimos anos uno de los problemas mas acuciantes del panorama tecnologico y de salud publica. En el primero de los casos porque las inversiones realizadas son enormes y en el segundo porque cada vez es mayor el numero de articulos, "technical reports" e informes medicos que afirman la existencia de una cierta causalidad, aunque sea debil, entre los campos electromagneticos y ciertos cuadros sintomatologicos. En nuestro caso, hemos dedicado bastantes esfuerzos a investigar el llamado "sindrome de radiofrecuencia / microondas", denominado asi en la literatura cientifica por presentarse en operarios de estaciones de radar y en trabajadores de potentes emisoras de radio y television. En esta memoria presentamos un resumen del trabajo realizado durante los ultimos anos en la medida de la contaminacion electromagnetica ambiental asociado a las comunicaciones inalambricas. En ella se recogen los fundamentos fisicos y propiedades de las ondas electromagneticas, la tecnologia empleada en los sistemas de telefonia celular y los antecedentes relativos a la investigacion de la interaccion de las ondas electromagneticas con organismos vivos. Se desarrolla un procedimiento de medida que ha conducido a la elaboracion de los primeros "mapas de radiofrecuencia" similares, en el aspecto descriptivo, a los mapas de ruido desarrollados en el area de la contaminacion acustica. Por ultimo, se analiza la respuesta subjetiva de los residentes, personas que viven en el entorno de cobertura de las estaciones base de telefonia movil y que se ven sometidos a determinados niveles de radiacion electromagnetica, con el fin de situar este fenomeno al nivel que le corresponde en el ambito de la respuesta subjetiva ciudadana.

The GEANT4 toolkit capability in the hadron therapy field: simulation of a transport beam line

NASA Astrophysics Data System (ADS)

Cirrone, G. A. P.; Cuttone, G.; Di Rosa, F.; Raffaele, L.; Russo, G.; Guatelli, S.; Pia, M. G.

2006-01-01

At Laboratori Nazionali del Sud of the Instituto Nazionale di Fisica Nucleare of Catania (Sicily, Italy), the first Italian hadron therapy facility named CATANA (Centro di AdroTerapia ed Applicazioni Nucleari Avanzate) has been realized. Inside CATANA 62 MeV proton beams, accelerated by a superconducting cyclotron, are used for the radiotherapeutic treatments of some types of ocular tumours. Therapy with hadron beams still represents a pioneer technique, and only a few centers worldwide can provide this advanced specialized cancer treatment. On the basis of the experience so far gained, and considering the future hadron-therapy facilities to be developed (Rinecker, Munich Germany, Heidelberg/GSI, Darmstadt, Germany, PSI Villigen, Switzerland, CNAO, Pavia, Italy, Centro di Adroterapia, Catania, Italy) we decided to develop a Monte Carlo application based on the GEANT4 toolkit, for the design, the realization and the optimization of a proton-therapy beam line. Another feature of our project is to provide a general tool able to study the interactions of hadrons with the human tissue and to test the analytical-based treatment planning systems actually used in the routine practice. All the typical elements of a hadron-therapy line, such as diffusers, range shifters, collimators and detectors were modelled. In particular, we simulated the Markus type ionization chamber and a Gaf Chromic film as dosimeters to reconstruct the depth (Bragg peak and Spread Out Bragg Peak) and lateral dose distributions, respectively. We validated our simulated detectors comparing the results with the experimental data available in our facility.

[La combinazione di gemcitabina e oxaliplatino (GEMOX) nel trattamento del carcinoma pancreatico in fase avanzata di malattia: le notizie sulla mia morte sono state esagerate?

PubMed

Giuliani, Jacopo; Bonetti, Andrea

2017-12-01

Riassunto. L'analisi è stata condotta al fine di valutare l'effetto sia sulla sopravvivenza globale (OS) sia sulla sopravvivenza libera da progressione di malattia (PFS) della chemioterapia di combinazione in prima linea per il carcinoma pancreatico in fase avanzata di malattia. La presente analisi è limitata agli studi randomizzati controllati (RCT) di fase III. Successivamente è stata applicata la European Society for Medical Oncology Magnitude of Clinical Benefit Scale (ESMO-MCBS) agli RCT di fase III analizzati per ricavare uno score relativo all'entità del beneficio clinico ottenuto per ciascun RCT. Sono state calcolate inoltre le differenze in termini di PFS tra i diversi bracci di trattamento rapportandole con i costi dei farmaci necessari per ottenere il beneficio di PFS. La nostra analisi ha valutato 11 RCT di fase III, per un totale di 4572 pazienti. Combinando i costi della terapia con la misura dell'efficacia espressa dalla PFS, è stato ottenuto un costo di 74,12 euro (€) per mese di vita guadagnato in termini di PFS con la combinazione di 5-fluorouracil, leucovorin, irinotecan e oxaliplatino (FOLFIRINOX), 90,14 € per la combinazione di gemcitabina e oxaliplatino (GEMOX) e 4708,7 € per la combinazione di nab-paclitaxel e gemcitabina. Da questo punto di vista riteniamo che l'utilizzo delle "vecche chemioterapie di combinazione" (per es., GEMOX) non dovrebbe essere completamente abbandonato, ma valutato sul singolo paziente, sulla base di diversi fattori (età, ECOG PS, comorbilità, carico di malattia), al fine di ottenere una reale "tailored therapy".

Severity and workload related to adverse events in the ICU.

PubMed

Serafim, Clarita Terra Rodrigues; Dell'Acqua, Magda Cristina Queiroz; Castro, Meire Cristina Novelli E; Spiri, Wilza Carla; Nunes, Hélio Rubens de Carvalho

2017-01-01

To analyze whether an increase in patient severity and nursing workload are correlated to a greater incidence of adverse events (AEs) in critical patients. A prospective single cohort study was performed on a sample of 138 patients hospitalized in an intensive care unit (ICU). A total of 166 AEs, occurred, affecting 50.7% of the patients. Increased patient severity presented a direct relationship to the probability of AEs occurring. However, nursing workload did not present a statistically significant relationship with the occurrence of AEs. The results cast light on the importance of using evaluation tools by the nursing personnel in order to optimize their daily activities and focus on patient safety. Analisar se o aumento da gravidade do paciente e a carga de trabalho de enfermagem está relacionado à maior incidência de Eventos Adversos (EAs) em pacientes críticos. Estudo de coorte única, prospectivo, com amostra de 138 pacientes internados em uma Unidade de Terapia Intensiva (UTI). Ao todo, foram evidenciados 166 EAs, que acometeram 50,7% dos pacientes. O aumento da gravidade do paciente apresentou relação direta com a chance de ocorrência de EAs. Entretanto, a carga de trabalho de enfermagem não apresentou relação estatisticamente significativa, na ocorrência de EAs. Os resultados permitem refletir acerca da importância da equipe de enfermagem, em utilizar instrumentos de avaliação, com o objetivo de melhorar e planejar suas ações diárias, com foco na segurança do paciente.

Effectiveness and safety of a 6-month treatment with paricalcitol in patients on hemodialysis with secondary hyperparathyroidism.

PubMed

Olaizola, Inés; Caorsi, Hena; Fajardo, Laura; Ferreiro, Alejandro; Campistrus, Nieves; Dolinsky, Deyanira; Petraglia, Alicia; Ambrosoni, Pablo

2016-01-01

The mineral bone disorder, particularly secondary hyperparathyroidism, in chronic kidney disease (CKD) has a systemic impact affecting not only bone metabolism. Therefore its correction is important to prevent cardiovascular, inflammatory and immune diseases. To assess the effectiveness and safety of intravenous paricalcitol administered over a 6 month period for the treatment of secondary hyperparathyroidism (SHPT) in patients undergoing conventional hemodialysis, with close follow-up of treatment response. A phase 4 clinical trial was performed comparing clinical and laboratory data before and after 6 months of treatment. SHPT patients undergoing hemodialysis who were naïve to vitamin D metabolites or had failed to current therapy were included. Clinical and laboratory characteristics were analyzed. Efficacy analyses were based on intact parathyroid hormone (iPTH) levels and were performed using data from patients who completed 6 months of treatment. Nineteen of the 26 patients enrolled completed 6 months of treatment. All patients exhibited reduced baseline iPTH levels (mean reduction, 371.8 pg/mL; 95% CI, 273.3-470.2 pg/mL]; 17 patients (89.5%) had reductions exceeding 30%. Twelve patients (63%) achieved therapeutic success (defined as iPTH serum levels 150-300 pg/mL), with a median time of 2 months from the beginning of treatment. All reported episodes of hypercalcemia (n = 2) and hyperphosphatemia (n = 34) were asymptomatic. No major therapy-related serious AEs were reported. Paricalcitol was safely administered and was associated with significant decreases in iPTH levels over the study period. A doença metabólica óssea, em particular o hiperparatireoidismo secundário, na doença renal crônica (DRC) tem um impacto sistêmico que afeta nem só o metabolismo ósseo. Por tanto, sua correção é importante para prevenir as doenças do sistema imunitário, inflamatório e cardiovascular. Avaliar a eficácia e a segurança do paricalcitol intravenoso administrado durante um período de 6 meses no tratamento do hiperparatireoidismo secundário (SHPT) em pacientes submetidos a hemodiálise convencional, com acompanhamento de perto da resposta do tratamento. Realizou-se um ensaio clínico de fase 4 que comparava os dados clínicos com os dados do laboratório antes e depois dos 6 meses de tratamento. Incluíram-se os pacientes SHPT em hemodiálise sem experiência com os metabólitos da vitamina D ou que fracassaram com a terapia em uso. Analisaram-se as características clínicas e de laboratório. As análises de eficácia se basearam nos níveis do hormônio da paratireóide intacto (iPTH) e foram realizadas usando dados dos pacientes que completaram os 6 meses de tratamento. Dezenove dos 26 pacientes registrados completaram os 6 meses de tratamento. Todos os pacientes mostraram níveis de referência iPTH reduzidos (redução média, 371,8 pg/mL; 95% CI, 273,3-470.2 pg/mL]; 17 pacientes (89,5%) tiveram reduções superiores a 30%. Doze pacientes (63%) conseguiram o sucesso terapêutico (definido como níveis de soros iPTH de 150-300 pg/mL), com um tempo médio de 2 meses a partir do início do tratamento. Todos os episódios de hipercalcemia (n = 2) e de hiperfosfatemia (n = 34) reportados foram assintomáticos. Não se informaram AEs graves importantes relacionados à terapia. O paricalcitol foi administrado de forma segura e se associou às reduções significativas nos níveis de iPTH durante o período do estudo.

Reproductive aspects and knowledge of family planning among women with Acquired Immunodeficiency Syndrome.

PubMed

Lima, Ivana Cristina Vieira de; Cunha, Maria da Conceição Dos Santos Oliveira; Cunha, Gilmara Holanda da; Galvão, Marli Teresinha Gimeniz

2017-05-25

To analyze the reproductive aspects and knowledge of family planning among women with Acquired Immunodeficiency Syndrome (AIDS). Cross-sectional and descriptive study carried out from January to December, 2015, in the outpatient care of infectious disease unit in a hospital located in Fortaleza, Ceará. Data were collected through a form applied by interview in a private setting. 102 women participated in the study. Most were aware that they were serologically positive with human immunodeficiency virus (HIV) during prenatal care (96.1%) and did not intend to have more children (63.7%). Women who were less than 39 years of age, had a higher educational level, and a shorter time of antiretroviral therapy had better chances of having children (p≤0.05). Having a steady partner increased the chance of desiring to have children, while tubal ligation was higher among women that did not receive counseling on family planning. Knowledge of family planning was limited because of lack of assistance provided by health professionals. Analisar aspectos reprodutivos e conhecimento sobre planejamento familiar de mulheres com síndrome da imunodeficiência adquirida (Aids). Estudo transversal, descritivo, realizado de janeiro a dezembro de 2015, no ambulatório de infectologia de um hospital em Fortaleza, Ceará. Os dados foram coletados por meio de formulário, aplicado por entrevista em ambiente privativo. Participaram do estudo 102 mulheres. A maioria delas teve conhecimento da sorologia positiva para vírus da imunodeficiência humana (HIV) durante o pré-natal (96,1%), e estas não pretendiam mais ter filhos (63,7%). Mulheres com idade menor que 39 anos, maior escolaridade e menor tempo de terapia antirretroviral tiveram maiores chances de ter filhos (p≤0,05). Mulheres com idade menor que 39 anos e maior escolaridade tiveram maiores chances de ter informações corretas sobre ter filhos na vigência do HIV (p≤0,05). Ter parceiro fixo aumentou a chance de desejar ter filhos, enquanto a laqueadura tubária foi maior em mulheres que não receberam orientações sobre planejamento familiar. A maioria das mulheres com Aids não pretendem mais ter filhos. O conhecimento sobre o planejamento familiar foi limitado por falta de orientações pelos profissionais de saúde. Analizar aspectos reproductivos y el conocimiento acerca de planificación familiar de las mujeres con síndrome de inmunodeficiencia adquirida (SIDA). Estudio transversal, descriptivo realizado de enero a diciembre de 2015, en la sala de enfermedades infecciosas de un hospital de Fortaleza, Ceará. Los datos fueron recolectados a través de una entrevista semiestructurada de forma de cuestionario en un ámbito privado. El estudio incluyó a 102 mujeres. La mayoría de ellos tenían conocimiento de ser seropositivas para el virus de la inmunodeficiencia humana (VIH) durante la atención prenatal (96,1%), y que no tenía intención de tener más hijos (63,7%). Mujeres menores de 39 años, con educación superior y terapia antirretroviral más corta eran más propensas a tener hijos (p=0,05). Mujeres con edades de menos de 39 años y más educación tenían más probabilidades de tener la información correcta acerca de tener hijos en presencia del VIH (p=0,05). Tener pareja estable aumentó la posibilidad de desear tener hijos, mientras que la ligadura de trompas fue mayor en las mujeres que no han recibido orientación sobre la planificación familiar. La mayoría de las mujeres con SIDA no tienen intención de tener hijos. El conocimiento acerca de la planificación familiar se vio limitada por la falta de orientación por los profesionales de la salud.

Online measurement of fluence and position for protontherapy beams

NASA Astrophysics Data System (ADS)

Benati, C.; Boriano, A.; Bourhaleb, F.; Cirio, R.; Cirrone, G. A. P.; Cornelius, I.; Cuttone, G.; Donetti, M.; Garelli, E.; Giordanengo, S.; Guérin, L.; La Rosa, A.; Luparia, A.; Marchetto, F.; Martin, F.; Meyroneinc, S.; Peroni, C.; Pittà, G.; Raffaele, L.; Sabini, M. G.; Valastro, L.

2004-09-01

Tumour therapy with proton beams has been used for several decades in many centres with very good results in terms of local control and overall survival. Typical pathologies treated with this technique are located in head and neck, eye, prostate and in general at big depths or close to critical organs. The Experimental Physics Department of the University of Turin and the local Section of INFN, in collaboration with INFN Laboratori Nazionali del Sud Catania and Centre de Protontherapie de Orsay Paris, have developed detector systems that allow the measurement of beam position and fluence, obtained in real time during beam delivery. The centre in Catania (CATANA: Centro di AdroTerapia ed Applicazioni Nucleari Avanzate) has been treating patients with eye pathologies since spring 2002 using a superconducting cyclotron accelerating protons up to 62 MeV.This kind of treatments need high-resolution monitor systems and for this reason we have developed a 256-strip segmented ionisation chamber, each strip being 400 μm wide, with a total sensitive area 13×13 cm2. The Centre de Protontherapie de Orsay (CPO) has been operational since 1991 and features a synchrocyclotron used for eye and head and neck tumours with proton beams up to 200 MeV. The monitor system has to work on a large surface and for this purpose we have designed a pixel-segmented ionisation chamber, each pixel being 5×5 mm2, for a total active area of 16×16 cm2. The results obtained with two prototypes of the pixel and strip chambers demonstrate that the detectors allow the measurement of fluence and centre of gravity as requested by clinical specifications.

Use of technologies in intravenous therapy: contributions to a safer practice.

PubMed

Moreira, Ana Paula Amorim; Escudeiro, Cristina Lavoyer; Christovam, Bárbara Pompeu; Silvino, Zenith Rosa; Carvalho, Márglory Fraga de; Silva, Roberto Carlos Lyra da

2017-01-01

To identify what are the difficulties of the nursing staff in the management of technologies during intravenous therapy (IVT) and discuss the difficulties identified under the perspective of patient's safety. Descriptive study of qualitative approach with data collected by semi-structured interview and analyzed by the Alceste software. The greatest difficulty of cognitive and technical emphasis was the lack of training; and regarding administrative emphasis, the greatest difficulty was the lack of material and human resources. Infusion pumps and their proper use were highlighted as the technological resource that most contributed to patient safety. The lack of training is presented as the greatest difficulty of nursing professionals and permeates safety issues of both patient and professional when using the hard technologies in IVT. Training is essential to the development of techniques, considered nursing tools. Identificar quais são as dificuldades da equipe de Enfermagem no manejo das tecnologias durante a terapia intravenosa (TIV) e discutir as dificuldades identificadas sob a perspectiva da segurança do paciente. abordagem qualitativa, do tipo descritivo com dados coletados por entrevista semiestruturada e analisados pelo programa Alceste. A maior dificuldade de ênfase cognitiva e técnica foi a falta de treinamento; e de ênfase administrativa, foi a falta de recursos materiais e humanos. As bombas de infusão e sua utilização adequada foram destacadas como o recurso tecnológico que mais contribuiu para a segurança do paciente. A falta de treinamento é apresentada como a maior dificuldade dos profissionais de Enfermagem e permeia as questões de segurança do paciente e do profissional ao utilizar as tecnologias duras na TIV. O treinamento é imprescindível para o desenvolvimento das técnicas, consideradas como ferramentas do fazer da Enfermagem.

Good practices in collecting umbilical cord and placental blood.

PubMed

Lopes, Lauren Auer; Bernardino, Elizabeth; Crozeta, Karla; Guimarães, Paulo Ricardo Bittencourt

2016-08-18

to identify the factors related to the quality of umbilical cord and placental blood specimens, and define best practices for their collection in a government bank of umbilical cord and placental blood. this was a descriptive study, quantitative approach, performed at a government umbilical cord and placental blood bank, in two steps: 1) verification of the obstetric, neonatal and operational factors, using a specific tool for gathering data as non-participant observers; 2) definition of best practices by grouping non-conformities observed before, during and after blood collection. The data was analyzed using descriptive statistics and the following statistical software: Statistica(r) and R(r). while there was a correlation with obstetrical and neonatal factors, there was a larger correlation with operational factors, resulting in the need to adjust the professional practices of the nursing staff and obstetrical team involved in collecting this type of blood. Based on these non-conformities we defined best practices for nurses before, during and after blood collection. the best practices defined in this study are an important management tool for the work of nurses in obtaining blood specimens of high cell quality. identificar fatores relacionados à qualidade das amostras do sangue de cordão umbilical e placentário e definir boas práticas para sua coleta em um banco público de sangue de cordão umbilical e placentário. pesquisa descritiva, abordagem quantitativa, realizada em um banco público de sangue de cordão umbilical e placentário, desenvolvida em duas etapas: 1) verificação dos fatores obstétricos, neonatais e operacionais, obtidos por coleta em instrumento próprio e observação não participante; 2) definição das boas práticas, por meio do agrupamento de não-conformidades observadas antes, durante e após a coleta do sangue. Os dados foram analisados por meio da estatística descritiva, utilizando-se dos softwares Statistica(r) e R(r). houve correlação da influência dos fatores obstétricos e neonatais em menor escala quando comparados aos fatores operacionais, resultando na necessidade de readequar a prática profissional do enfermeiro e da equipe obstétrica envolvida no processo da coleta desse tipo de sangue. A partir das não-conformidades foram definidas boas práticas para o enfermeiro antes, durante e após a coleta. as boas práticas definidas neste estudo são importante ferramenta gerencial para o trabalho do enfermeiro na obtenção de amostras de sangue com alta qualidade celular. identificar factores relacionados a la calidad de las muestras de la sangre del cordón umbilical y de la placenta y definir buenas prácticas para su recolección en un banco público de sangre del cordón umbilical y de la placenta. investigación - descriptiva, abordaje cuantitativo, realizada en un banco público de sangre - del cordón umbilical y de la placenta, desarrollada en dos etapas: 1) verificación de los factores obstétricos, neonatales y operacionales, obtenidos por recolección con instrumento propio y observación no participante; 2) definición de las buenas prácticas, por medio del agrupamiento de no-conformidades observadas antes, durante y después de la recolección de la sangre. Los datos fueron analizados por medio de la estadística descriptiva, utilizando los softwares Statistica(r) y R(r). hubo correlación de la influencia de los factores obstétricos y neonatales en menor escala cuando comparados a los factores operacionales, resultando en la necesidad de readecuar la práctica profesional del enfermero y del equipo obstétrico que participa en el proceso de la recolección de ese tipo de sangre. A partir de las no-conformidades fueron definidas buenas prácticas para el enfermero antes, durante y después de la recolección. las buenas prácticas definidas en este estudio son importante herramienta administrativa para el trabajo del enfermero en la obtención de muestras de sangre con alta calidad celular.

PubMed

Oyarce Merino, Karina; Valladares Vega, Macarena; Elizondo-Vega, Roberto; Obregón, Ana María

2016-11-29

Introducción: cambios socioculturales como el incremento en el sedentarismo y el consumo de alimentos ricos en grasas y azúcares, sumado a características genéticas, han producido un aumento en las cifras de obesidad a nivel mundial. La evaluación temprana en niños, mediante el establecimiento de perfi les genéticos asociados a obesidad y a la regulación metabólica y hedónica de la alimentación, complementado con estudios de la conducta alimentaria, nos permitiría predecir la predisposición a la obesidad en etapas adultas.Objetivo: revisar los conceptos asociados a la conducta alimenticia, enfocándose en la regulación hedónica, que puede convertirse en un parámetro predictivo de obesidad en niños.Material y métodos: se revisó la bibliografía asociada a obesidad infantil y a la regulación homeostática y hedónica de la obesidad, como también parámetros génicos asociados a la obesidad. En la búsqueda de artículos se incluyó el trabajo en animales y humanos (adultos y niños, pero con énfasis en niños).Resultados: se analizaron los mecanismos celulares de la regulación de la ingesta, así como los estudios de conducta alimentaria en niños, entregando antecedentes y carencias en el desarrollo investigativo para la predicción de la obesidad infantil.Conclusión: la regulación hedónica de la ingesta alimenticia en niños, como perfi les genéticos asociados a receptores de dopamina, puede convertirse en un importante predictor de la obesidad. Es necesario incrementar el número de estudios que permitan defi nir de mejor forma, cuáles son los mejores parámetros para predecir el desarrollo de la obesidad adulta.

[Changes induced by hypertonic solutions in the transportation of calcium by the cardiac reticular sarcoplasma].

PubMed

Sierra, M; Holguín, J A

1979-01-01

In the sarcoplasmic reticulum of the myocardium, celular organell which function is to regulate the cytoplasmic concentration of calcium in contraction and relaxation, we have studied the effect of hypertonic solutions of sucrose between 1 and 6.96 times the normal tonicity in order to observe the behavior of the internal linked or free calcium of this structure, as well as to prove the hypothesis that hypertonic solutions encourage the calcium exit of the sarcoplasmatic reticulum with the resulting signs of contractures. The following results were obtained: 1. The ATP hydrolisis and calcium transport rate are 14% and 90% respectively of the maximum speeds of 10(-5) M in calcium, while for concentrations of 10(-7) M or ess of the said cation, the transport rates and the ATPase do not reach 5% of the maximum values. 2. Between 1 and 2.54 times of the normal tonicity the calcium uptake remains between 400 and 500 nmoles of calcium/mg protein/min, the transported amount of calcium varies between 14 and 16 nmoles/mg protein and the rate of the ATP hydrolysis increases a 37% to 0.4 M in sucrose. 3. Between 0.4 and 1.2 M in sucrose of 2.54 to 6.96 times the isotonicity, the calcium transport rate velocity as well as the ATP hydrolisis are strongly inhibited. The vesicles volume minimizes and the amount of linked calcium remains within the control values, proving that the capacity of linking this cathion is independent from sarcoplasmic reticulum volume. These results show that the sarcoplasmic reticulum is involved in the contractures induced by hypertonic solutions in intact cells, since the osmolarity increase produces changes of volume which results in a decrease of the calcium transportation velocity or in an increase of the exit of said cathion.

Culture-bound syndromes in migratory contexts: the case of Bolivian immigrants.

PubMed

Roldán-Chicano, María Teresa; Fernández-Rufete, José; Hueso-Montoro, César; García-López, María Del Mar; Rodríguez-Tello, Javier; Flores-Bienert, María Dolores

2017-07-10

to describe the culture-bound syndromes maintained by Bolivian immigrants in the new migratory context and analyze the care processes of these health problems. qualitative research with an ethnographic methodological approach. Sample: 27 Bolivian immigrants. In-depth interviews and participatory observation were the strategies used for data collection. Data were classified and categorized into logical schemes manually and using the ATLAS-ti program v.5. susto, "wayras", amartelo, pasmo de sol, pasmo de luna and pasmo de sereno are some of the folk illnesses that affect the Bolivian immigrants and that they have to treat in the new migratory context. in the new environment, the group under study preserves culture-bound syndromes that are common in their country of origin. The care strategies used for these health problems are adapted to the resources of the new context and based on interactions with the domestic environment, biomedicine and traditional medicine. It was observed the need for the health professionals to realize that the efficacy of certain therapies occurs within the scope of cultural beliefs and not in that of the scientific evidence. descrever as síndromes vinculadas à cultura mantidas pelos imigrantes bolivianos no novo contexto migratório e analisar os processos de cuidado para esses problemas de saúde. projeto de pesquisa de natureza qualitativa e com abordagem metodológica etnográfica. Amostra: 27 imigrantes bolivianos. As estratégias para a coleta de dados foram as entrevistas em profundidade e a observação participativa. Os dados foram classificados e categorizados em esquemas lógicos manualmente e por meio do programa ATLAS-ti v.5. o susto, os "wayras", o amartelo (tristeza), o pasmo de sol, o pasmo de lua e o pasmo de sereno são algumas das síndromes de caráter popular que acometem os imigrantes bolivianos, e que eles tratam no novo contexto migratório. no novo ambiente, as síndromes vinculadas à cultura, comuns em seu país de origem, são mantidas pelo grupo estudado. As formas de cuidado para esses problemas de saúde são adaptadas aos recursos do novo contexto e baseadas em interações com o ambiente doméstico, a biomedicina e a medicina tradicional. Foi constatada a necessidade de que os profissionais de saúde reconheçam que a eficácia de determinadas terapias se dá no âmbito das crenças culturais e não no âmbito da comprovação científica. describir los síndromes de filiación cultural que mantienen los inmigrantes bolivianos en el nuevo contexto migratorio y analizar los procesos de atención de estos padecimientos. diseño de investigación de carácter cualitativo con enfoque metodológico etnográfico. Muestra: 27 inmigrantes bolivianos. Las estrategias para recoger datos fueron las entrevistas en profundidad y la observación participante. Los datos se categorizaron y ordenaron en esquemas lógicos manualmente y a través del programa ATLAS-ti v.5. el susto, los "wayras", el amartelo, el pasmo de sol, el pasmo de luna y el pasmo de sereno son algunos de los síndromes de carácter folk que los inmigrantes bolivianos padecen y tratan en el nuevo contexto migratorio. en el nuevo entorno, el colectivo estudiado mantiene síndromes de filiación cultural comunes en su país de origen. Las formas de atención de éstos padecimientos se adaptan a los recursos del nuevo contexto y se basan en transacciones con el ámbito doméstico, la biomedicina y la medicina tradicional. Se constata la necesidad de que el profesional sanitario reconozca que la efectividad percibida de ciertas terapias opera dentro del ámbito de las creencias culturales y no en el de la evidencia científica.

Effective tobacco control measures: agreement among medical students.

PubMed

Martins, Stella Regina; Paceli, Renato Batista; Bussacos, Marco Antônio; Fernandes, Frederico Leon Arrabal; Prado, Gustavo Faibischew; Lombardi, Elisa Maria Siqueira; Terra-Filho, Mário; Santos, Ubiratan Paula

2017-01-01

To determine the level of agreement with effective tobacco control measures recommended by the World Health Organization and to assess the attitudes toward, knowledge of, and beliefs regarding smoking among third-year medical students at University of São Paulo School of Medicine, located in the city of São Paulo, Brazil. Between 2008 and 2012, all third-year medical students were invited to complete a self-administered questionnaire based on the Global Health Professionals Student Survey and its additional modules. The study sample comprised 556 students. The level of agreement with the World Health Organization recommendations was high, except for the components "received smoking cessation training" and "raising taxes is effective to reduce the prevalence of smoking". Most of the students reported that they agree with banning tobacco product sales to minors (95%), believe that physicians are role models to their patients (84%), and believe that they should advise their patients to quit cigarette smoking (96%) and using other tobacco products (94%). Regarding smoking cessation methods, most of the students were found to know more about nicotine replacement therapy than about non-nicotine therapies (93% vs. 53%). Only 37% of the respondents were aware of the importance of educational antismoking materials, and only 31% reported that they believe in the effectiveness of encouraging their patients, during medical visits. In our sample, the prevalence of current cigarette smoking was 5.23%; however, 43.82% of the respondents reported having experimented with water-pipe tobacco smoking. Our results revealed the need to emphasize to third-year medical students the importance of raising the prices of and taxes on tobacco products. We also need to make students aware of the dangers of experimenting with tobacco products other than cigarettes, particularly water-pipe tobacco smoking. Determinar o grau de concordância com medidas eficazes de controle do tabaco recomendadas pela Organização Mundial da Saúde e avaliar as atitudes, o conhecimento e as crenças a respeito do tabagismo em alunos do terceiro ano de medicina da Faculdade de Medicina da Universidade de São Paulo, em São Paulo (SP). Entre 2008 e 2012, todos os alunos do terceiro ano de medicina foram convidados a preencher um questionário autoaplicável baseado na Global Health Professions Student Survey e em seus módulos adicionais. A amostra consistiu em 556 estudantes. O grau de concordância com as recomendações da Organização Mundial da Saúde foi alto, à exceção de "receberam treinamento a respeito de cessação do tabagismo" e "aumentar os impostos é uma medida eficaz para reduzir a prevalência do tabagismo". A maioria dos estudantes relatou que concorda com a proibição da venda de produtos do tabaco a menores de idade (95%), acredita que os médicos são modelos de comportamento para seus pacientes (84%) e acredita que deveriam aconselhar seus pacientes a parar de fumar cigarros (96%) e de usar outros produtos do tabaco (94%). No tocante aos métodos de cessação do tabagismo, observamos que a maioria dos estudantes sabe mais sobre terapia de reposição da nicotina do que sobre terapias não nicotínicas (93% vs. 53%). Apenas 37% dos participantes estavam cientes da importância de material educacional antitabagismo, e apenas 31% relataram que acreditam na eficácia de incentivar seus pacientes, durante as consultas médicas, a parar de fumar. Em nossa amostra, a prevalência de tabagismo atual foi de 5,23%; entretanto, 43,82% dos participantes relataram ter experimentado fumar tabaco com um narguilé. Nossos resultados revelaram a necessidade de deixar claro para os alunos do terceiro ano de medicina o quão importante é aumentar os preços e impostos dos produtos do tabaco. É também preciso conscientizar os alunos dos perigos de experimentar outros produtos do tabaco que não os cigarros, particularmente o narguilé.

Factors influencing the missed nursing care in patients from a private hospital.

PubMed

Hernández-Cruz, Raúl; Moreno-Monsiváis, María Guadalupe; Cheverría-Rivera, Sofía; Díaz-Oviedo, Aracely

2017-07-10

to determine the factors that influence the missed nursing care in hospitalized patients. descriptive correlational study developed at a private hospital in Mexico. To identify the missed nursing care and related factors, the MISSCARE survey was used, which measures the care missed and associated factors. The care missed and the factors were grouped in global and dimension rates. For the analysis, descriptive statistics, Spearman's correlation and simple linear regression were used. Approval for the study was obtained from the ethics committee. the participants were 71 nurses from emergency, intensive care and inpatient services. The global missed care index corresponded to M=7.45 (SD=10.74); the highest missed care index was found in the dimension basic care interventions (M=13.02, SD=17.60). The main factor contributing to the care missed was human resources (M=56.13, SD=21.38). The factors related to the care missed were human resources (rs=0.408, p<0.001) and communication (rs=0.418, p<0.001). the nursing care missed is mainly due to the human resource factor; these study findings will permit the strengthening of nursing care continuity. determinar os fatores que influenciam o cuidado de enfermagem omitido em pacientes hospitalizados. estudo descritivo correlacional, desenvolvido em um hospital particular do México. Para identificar o cuidado omitido e fatores relacionados, utilizou-se o instrumento MISSCARE, que mede o cuidado omitido e os fatores associados. O cuidado omitido e os fatores foram agrupados em índices globais e por dimensões. Para fins de análise, foi utilizada estatística descritiva, correlação de Spearman e regressão linear simples. O estudo recebeu aprovação de comité de ética. participaram 71 enfermeiras dos serviços de urgências, terapia intensiva e hospitalização. O índice global de cuidado omitido mostrou um coeficiente M=7,45 (DE=10,74); o índice com maior cuidado omitido correspondeu à dimensão de intervenções de cuidado básico (M=13,02, DE=17,60). O principal fator que contribuiu ao cuidado omitido foi o de recursos humanos (M=56,13, DE=21,38). Os fatores relacionados ao cuidado omitido foram os recursos humanos (rs=0,408, p<0,001) e comunicação (rs=0,418, p<0,001). o cuidado omitido de enfermagem atribui-se principalmente ao fator de recursos humanos; com base nos resultados deste estudo pode-se fortalecer a continuidade do cuidado de enfermagem. determinar los factores que influyen en el cuidado de enfermería perdido en pacientes hospitalizados. estudio descriptivo correlacional, se realizó en un hospital privado de México. Para identificar el cuidado perdido y factores relacionados se utilizó el instrumento MISSCARE que mide el cuidado perdido y los factores asociados. El cuidado perdido y los factores se agruparon en índices globales y por dimensiones. Para el análisis se utilizó estadística descriptiva, correlación de Spearman y regresión lineal simple. El estudio fue aprobado por el comité de ética. participaron 71 enfermeras de los servicios de urgencias, terapia intensiva y hospitalización. El índice global de cuidado perdido mostró una M=7,45 (DE=10,74); el índice con mayor cuidado perdido correspondió a la dimensión de intervenciones de cuidado básico (M=13,02, DE=17,60). El principal factor que contribuyó en el cuidado perdido, fue el de recursos humanos (M=56,13, DE=21,38). Los factores relacionados con el cuidado perdido fueron los de recursos humanos (rs=0,408, p<0,001) y comunicación (rs=0,418, p<0,001). el cuidado perdido de enfermería se atribuye principalmente al factor de recurso humano; los hallazgos de este estudio permitirán fortalecer la continuidad en el cuidado de enfermería.

Massage and Reiki used to reduce stress and anxiety: Randomized Clinical Trial.

PubMed

Kurebayashi, Leonice Fumiko Sato; Turrini, Ruth Natalia Teresa; Souza, Talita Pavarini Borges de; Takiguchi, Raymond Sehiji; Kuba, Gisele; Nagumo, Marisa Toshi

2016-11-28

to evaluate the effectiveness of massage and reiki in the reduction of stress and anxiety in clients at the Institute for Integrated and Oriental Therapy in Sao Paulo (Brazil). clinical tests randomly done in parallel with an initial sample of 122 people divided into three groups: Massage + Rest (G1), Massage + Reiki (G2) and a Control group without intervention (G3). The Stress Systems list and the Trace State Anxiety Inventory were used to evaluate the groups at the start and after 8 sessions (1 month), during 2015. there were statistical differences (p = 0.000) according to the ANOVA (Analysis of Variance) for the stress amongst the groups 2 and 3 (p = 0.014) with a 33% reductions and a Cohen of 0.78. In relation to anxiety-state, there was a reduction in the intervention groups compared with the control group (p < 0.01) with a 21% reduction in group 2 (Cohen of 1.18) and a 16% reduction for group 1 (Cohen of 1.14). Massage + Reiki produced better results amongst the groups and the conclusion is for further studies to be done with the use of a placebo group to evaluate the impact of the technique separate from other techniques. RBR-42c8wp. avaliar a efetividade da Massagem e Reiki na redução de estresse e ansiedade em clientes do Instituto de Terapia Integrada e Oriental, em São Paulo (Brasil). ensaio clínico controlado randomizado paralelo com amostra inicial de 122 pessoas divididas em 3 grupos Massagem+Repouso (G1), Massagem+Reiki (G2) e Controle sem intervenção (G3). Foram avaliados pela Lista de Sintomas de Stress e pelo Inventário de Ansiedade Traço-Estado, no início e após 8 sessões (1 mês), durante o ano de 2015. houve diferença estatística (p = 0,000) segundo ANOVA para o estresse entre os grupos 2 e 3 (33% de redução e Cohen de 0,98) e entre os grupos 1 e 3 (p = 0,014), 24% de redução e Cohen de 0,78. Para a ansiedade-estado, houve redução nos grupos de intervenção comparados ao grupo Controle (p < 0,01), com 21% de redução para o Grupo 2 (Cohen de 1,18) e 16% de redução para o grupo 1 (Cohen de 1,14). a Massagem+Reiki conseguiu melhores resultados entre os grupos e se sugere outro estudo com uso de placebo para o Reiki, para avaliar o alcance da técnica em separado. RBR-42c8wp. evaluar la efectividad de Masaje y Reiki para reducción del estrés y ansiedad en clientes del Instituto de Terapia Integrada y Oriental, en Sao Paulo, Brasil. ensayo clínico controlado aleatorizado paralelo, con muestra inicial de 122 personas divididas en 3 grupos Masaje+Reposo (G1), Masaje+Reiki (G2) y Control sin intervención (G3). Los participantes fueron evaluados a través de la Lista de Síntomas de Stress y por el Inventario de Ansiedad Rasgo-Estado, en el inicio y después de 8 sesiones (1 mes), durante el año de 2015. hubo diferencia estadística (p = 0,000) según ANOVA para el estrés entre los grupos 2 y 3 (33% de reducción y Cohen de 0,98) y entre los grupos 1 y 3 (p = 0,014), 24% de reducción y Cohen de 0,78. Para la ansiedad-estado, hubo reducción en los grupos de intervención comparados al grupo Control (p < 0,01), con 21% de reducción para el Grupo 2 (Cohen de 1,18) y 16% de reducción para el grupo 1 (Cohen de 1,14). entre los grupos, el Masaje+Reiki consiguió mejores resultados; se sugiere realizar otro estudio con uso de placebo para el Reiki, para evaluar el alcance de la técnica de forma separada. RBR-42c8wp.

Prototype of a computerized scale for the active search for potential organ donors.

PubMed

Ludwig, Érika Fernanda Dos Santos Bezerra; Pereira, Marta Cristiane Alves; Martinez, Yolanda Dora Évora; Mendes, Karina Dal Sasso; Rossaneis, Mariana Angela

2017-09-12

to develop a prototype of a computerized scale for the active search for potential organ and tissue donors. methodological study, with the analysis of 377 electronic medical records of patients who died due to encephalic death or cardiorespiratory arrest in the intensive care units of a tertiary hospital. Among the deaths due to cardiorespiratory arrest, the study aimed to identify factors indicating underreported encephalic death cases. The Acute Physiology and Chronic Health Evaluation II and Sepsis Related Organ Failure Assessment severity indexes were applied in the protocols. Based on this, a scale was built and sent to five experts for assessment of the scale content, and subsequently, it was computerized by using a prototyping model. 34 underreported encephalic death cases were identified in the medical records of patients with cardiorespiratory arrest. Statistically significant differences were found in the Wilcoxon test between the scores of hospital admissions in the intensive care unit and the opening of the encephalic death protocol for both severity indexes. the prototype was effective for identifying potential organ donors, as well as for the identification of the degree of organ dysfunction in patients with encephalic death. desenvolver protótipo de escala informatizada para busca ativa de potenciais doadores de órgãos e tecidos. pesquisa metodológica, com análise de 377 prontuários eletrônicos de pacientes que evoluíram a óbito, por morte encefálica, ou parada cardiorrespiratória, nas unidades de terapia intensiva de hospital terciário. Nos óbitos por parada cardiorrespiratória, buscou-se identificar fatores que indicassem subnotificação de morte encefálica. Nos protocolos, foram aplicados os índices de gravidade Acute Physiology and Chronic Health Evaluation II e Sepsis Related Organ Failure Assessment. A partir disso, construiu-se a escala que foi encaminhada a cinco especialistas, para avaliação de conteúdo, e, posteriormente, foi informatizada por modelo de prototipação. foram identificadas 34 subnotificações de morte encefálica nos prontuários dos casos de parada cardiorrespiratória. O teste de Wilcoxon demonstrou diferença estatisticamente significativa entre os escores de admissão em unidade de terapia intensiva e abertura do protocolo de morte encefálica, para ambos os índices de gravidade. o protótipo foi efetivo para identificação de potenciais doadores, bem como o grau de disfunção orgânica de pacientes em morte encefálica. desarrollar un prototipo de escala informatizada para la búsqueda activa de potenciales donantes de órganos y tejidos. investigación metodológica, con el análisis de 377 registros médicos electrónicos de pacientes, que fallecieron por muerte encefálica o paro cardiorrespiratorio, en las unidades de cuidados intensivos de un hospital terciario. Entre las muertes por paro cardiorrespiratorio, se buscó identificar los factores que indicasen subnotificación de muerte encefálica. Las puntuaciones de los índices de gravedad Acute Physiology and Chronic Health Evaluation II y Sepsis Related Organ Failure Assessment se aplicaron en los protocolos. A partir de eso, la escala fue construida y enviada a cinco expertos para la evaluación del contenido, y posteriormente, fue informatizada mediante un modelo de prototipación. se identificaron 34 casos de subnotificación de muerte encefálica en los registros médicos de los casos de paro cardiorrespiratorio. Se encontraron diferencias estadísticamente significativas en la prueba de Wilcoxon, entre las puntuaciones de los ingresos hospitalarios en unidad de cuidados intensivos y apertura del protocolo de muerte encefálica para ambos índices de gravedad. el prototipo fue eficaz para la identificación de potenciales donantes, así como para la identificación del grado de disfunción orgánica en pacientes con muerte encefálica.

Positive deviance as a strategy to prevent and control bloodstream infections in intensive care.

PubMed

Oliveira, Francimar Tinoco de; Ferreira, Maria Manuela Frederico; Araújo, Silvia Teresa Carvalho de; Bessa, Amanda Trindade Teixeira de; Moraes, Advi Catarina Barbachan; Stipp, Marluci Andrade Conceição

2017-04-03

To describe the application of positive deviance as a strategy to prevent and control bloodstream infections. An intervention study with nursing and medical team members working in an intensive care unit in a university hospital, between June and December 2014. The four steps of the positive defiance methodology were applied: to define, to determine, to discover and to design. In 90 days, 188 actions were observed, of these, 36.70% (n=69) were related to catheter dressing. In 81.15% (n=56) of these dressings, the professionals most adhered to the use of flexible sterile cotton-tipped swabs to perform antisepsis at catheter entry sites and fixation dressing. Positive deviance contributed to the implementation of proposals to improve work processes and team development related to problems identified in central venous catheter care. Descrever a aplicação do Positive Deviance como estratégia na prevenção e no controle da infecção de corrente sanguínea. Estudo de intervenção realizado na Unidade de Terapia Intensiva de um hospital universitário, com os membros das equipes de enfermagem e médica, de junho a dezembro de 2014. Foram aplicados os quatro passos da metodologia Positive Deviance: Definir, Determinar, Descobrir e Desenhar. Em 90 dias 188 ações foram observadas, destas, 36,70% (n=69) estavam relacionadas aos curativos dos cateteres. Em 81,15% (n=56) desses curativos, o uso da haste flexível estéril para realização da antissepsia do local de inserção do cateter e de sua placa de fixação foi a ação de maior adesão. O Positive Deviance auxiliou na implementação de propostas de melhorias de processo de trabalho e no desenvolvimento da equipe para os problemas identificados no cuidado com o cateter venoso central.

Alterações Induzidas Pelo Exercício no Número, Função e Morfologia de Monócitos de Ratos

PubMed Central

GUERESCHI, MARCIA G.; PRESTES, JONATO; DONATTO, FELIPE F.; DIAS, RODRIGO; FROLLINI, ANELENA B.; FERREIRA, CLÍLTON KO.; CAVAGLIERI, CLAUDIA R.; PALANCH, ADRIANNE C.

2008-01-01

O propósito desse estudo foi verificar as alterações histofisiológicas em monócitos e macrófagos induzidas por curtos períodos de exercícios. Ratos Wistar (idade = 2 meses, peso corporal = 200g) foram divididos em sete grupos (n=6 cada): controle sedentário (C), grupos exercitados (natação) na intensidade leve por 5 (5L), 10 (10L) e 15 minutos (15L), e grupos exercitados em intensidade moderada por 5 (5M), 10 (10M) e 15 minutes (15M). Na intensidade moderada os animais carregaram uma carga de 5% do peso corporal dos mesmos em seus respectivos dorsos. Os monócitos sangüíneos foram avaliados quanto à quantidade e morfologia e os macrófagos peritoneais foram analisados quanto à quantidade e atividade fagocitária. Os dados foram analisados usando ANOVA e Tukey’s post hoc test (p ≤ 0,05). Os grupos de intensidade leve e 5M apresentaram aumento nos níveis dos monócitos quando comparados com o controle. Foi observado aumento na área celular dos monócitos para os grupos 5L, 10L, 5M e 10M; a área nuclear aumentou para os grupos 10L, 5M e 10M em comparação com o controle. Houve aumento nos macrófagos peritoneais para os grupos 15L, 10M, 15M e diminuição no grupo 5M. A capacidade fagocitária dos macrófagos aumentou nos grupos de intensidade leve e para o grupo 10M. O exercício realizado por curtos períodos modulou o número e função dos macrófagos, assim como o número e morfologia dos monócitos, sendo tais alterações dependentes da intensidade. A soma das respostas agudas observadas nesse estudo pode exercer um efeito protetor contra doenças, podendo ser utilizada para a melhora da saúde e qualidade de vida.

Results after implementation of a protocol on the incidence of urinary tract infection in an intensive care unit.

PubMed

Miranda, Anna Letícia; Oliveira, Ana Lúcia Lyrio de; Nacer, Daiana Terra; Aguiar, Cynthia Adalgisa Mesojedovas

2016-09-09

to compare the results of urinary tract infection incidence, by means of the rate of indwelling urethral catheter use, and to identify microorganisms in urine cultures and surveillance cultures before and after the implementation of a clinical protocol for intensive care unit patients . urinary tract infection is defined as a positive urine culture > 105 CFU/mL, notified by the hospital infection control service, six months before and after the implementation of the protocol. The sample consisted of 47 patients, 28 reported before and 19 after implementation. The protocol established in the institution is based on the Ministry of Health manual to prevent healthcare-related infections; the goal is patient safety and improving the quality of health services. a negative linear correlation was observed between the later months of implementation and the reduction of reported cases of urinary tract infection, using the Spearman rank order coefficient (p = 0.045), and a reduction in the number of urine culture microorganisms (p = 0.026) using the Fisher exact test. educational interventions with implementation protocols in health institutions favor the standardization of maintenance of the invasive devices, which may reduce colonization and subsequent infections. comparar os resultados da incidência de infecção do trato urinário, por meio da taxa de utilização do cateter vesical de demora e identificar os micro-organismos na urocultura e cultura de vigilância antes e após a implementação de um protocolo assistencial em pacientes internados em unidade de terapia intensiva. definiu-se infecção do trato urinário pacientes com urocultura positiva >105 UFC/mL, notificados pelo Serviço de Controle de Infecção Hospitalar, seis meses antes e após a implementação do protocolo. A amostra foi constituída por 47 pacientes, sendo 28 notificados antes e 19 após. O protocolo, criado na instituição, é baseado no manual do Ministério da Saúde na prevenção de infecções relacionadas à assistência a saúde, como meta a segurança do paciente e o aperfeiçoamento na qualidade dos serviços de saúde. foi possível observar uma correlação linear negativa entre os meses posteriores da implementação e a redução dos casos notificados de infecção do trato urinário, pelo teste de Spearman (p=0,045) e redução do número de micro-organismos na urocultura (p=0,026) pelo teste de Fisher. intervenções educativas com implementação de protocolos nas instituições de saúde favorece a padronização da manutenção com dispositivos invasivos podendo reduzir a colonização e posterior casos de infecção. comparar los resultados de la incidencia de infección del tracto urinario, por medio de la tasa de utilización del catéter vesical de demora e identificar los microorganismos en el urocultivo y cultura de vigilancia antes y después de la implementación de un protocolo asistencial, en pacientes internados en unidad de terapia intensiva. se definió la infección del tracto urinario de pacientes con urocultivo positivo >105 UFC/mL, notificados por el Servicio de Control de Infección Hospitalario, seis meses antes y después de la implementación del protocolo. La muestra estuvo constituida por 47 pacientes, siendo 28 notificados antes y 19 después. El protocolo, creado en la institución, está basado en el manual del Ministerio de la Salud para la prevención de infecciones relacionadas a la asistencia la salud, siendo la meta la seguridad del paciente y el perfeccionamiento de la calidad de los servicios de la salud. fue posible observar una correlación linear negativa entre los meses posteriores a la implementación y la reducción de los casos notificados de infección del tracto urinario, por el test de Spearman (p=0,045) y reducción del número de microorganismos en el urocultivo (p=0,026) por el test de Fisher. las intervenciones educativas con implementación de protocolos en las instituciones de la salud favorecen la estandarización de la manutención de dispositivos invasivos, lo que podría reducir la colonización y posterior aparecimiento de casos de infección.

Epinephrine in cardiac arrest: systematic review and meta-analysis.

PubMed

Morales-Cané, Ignacio; Valverde-León, María Del Rocío; Rodríguez-Borrego, María Aurora

2016-12-08

evaluate the effectiveness of epinephrine used during cardiac arrest and its effect on the survival rates and neurological condition. systematic review of scientific literature with meta-analysis, using a random effects model. The following databases were used to research clinical trials and observational studies: Medline, Embase and Cochrane, from 2005 to 2015. when the Return of Spontaneous Circulation (ROSC) with administration of epinephrine was compared with ROSC without administration, increased rates were found with administration (OR 2.02. 95% CI 1.49 to 2.75; I2 = 95%). Meta-analysis showed an increase in survival to discharge or 30 days after administration of epinephrine (OR 1.23; 95% IC 1.05-1.44; I2=83%). Stratification by shockable and non-shockable rhythms showed an increase in survival for non-shockable rhythm (OR 1.52; 95% IC 1.29-1.78; I2=42%). When compared with delayed administration, the administration of epinephrine within 10 minutes showed an increased survival rate (OR 2.03; 95% IC 1.77-2.32; I2=0%). administration of epinephrine appears to increase the rate of ROSC, but when compared with other therapies, no positive effect was found on survival rates of patients with favorable neurological status. avaliar a efetividade da adrenalina na parada cardíaca e seu efeito na sobrevivência e no estado neurológico. revisão sistemática da literatura científica com meta-análise utilizando um modelo de efeitos aleatórios. Revisão em Medline, Embase e Cochrane, desde 2005 até 2015 de ensaios clínicos e estudos observacionais. observou-se aumento nas taxas de retorno de circulação espontânea com a administração de adrenalina (OR 2,02; 95% IC 1,49-2,75; I2=95%) comparadas com a não administração de adrenalina. A meta-análise mostrou um aumento da sobrevivência na alta ou depois de 30 dias da administração de adrenalina (OR 1,23; 95% IC 1,05-1,44; I2=83%). Quando estratificados por ritmos desfibrilháveis e não desfibrilháveis apareceu um aumento da sobrevivência nos ritmos não desfibrilháveis (OR 1,52; 95% IC 1,29-1,78; I2=42%). Também observou-se um incremento de sobrevivência na alta ou depois de 30 dias, quando administrada a adrenalina antes de 10 minutos, isto comparado com administração tardia (OR 2,03; 95% IC 1,77-2,32; I2=0%). a administração de adrenalina parece incrementar a taxa de retorno da circulação espontânea, mas não se tem encontrado um efeito positivo nas taxas de sobrevivência nem nas taxas de pacientes com estado neurológico favorável, em comparação com outras terapias. evaluar la efectividad de la adrenalina en el paro cardíaco y su efecto en la supervivencia y en el estado neurológico. revisión sistemática de la literatura científica con metaanálisis utilizando un modelo de efectos aleatorios. Revisión en Medline, Embase y Cochrane, desde 2005 hasta 2015, de ensayos clínicos y estudios observacionales. se observó aumento en las tasas de retorno de circulación espontánea cuando administrada adrenalina (OR 2,02; 95% IC 1,49-2,75; I2=95%) comparada con la no administración de adrenalina. El metaanálisis mostró un aumento de la supervivencia al alta hospitalaria o a los 30 días cuando administrada adrenalina (OR 1,23; 95% IC 1,05-1,44; I2=83%). La estratificación por ritmos desfibrilables y no desfibrilables mostró un aumento de la supervivencia en ritmos no desfibrilables (OR 1,52; 95% IC 1,29-1,78; I2=42%). También, se observó un incremento en la supervivencia al alta hospitalaria o a los 30 días en la administración de adrenalina antes de 10 minutos comparada con la administración tardía (OR 2,03; 95% IC 1,77-2,32; I2=0%). la administración de adrenalina parece incrementar la tasa de retorno de circulación espontánea, pero no se ha encontrado un efecto positivo en tasas de supervivencia ni en tasas de pacientes con estado neurológico favorable, en comparación con otras terapias.

Assessment and management of pain in newborns hospitalized in a Neonatal Intensive Care Unit: a cross-sectional study.

PubMed

Sposito, Natália Pinheiro Braga; Rossato, Lisabelle Mariano; Bueno, Mariana; Kimura, Amélia Fumiko; Costa, Taine; Guedes, Danila Maria Batista

2017-09-12

to determine the frequency of pain, to verify the measures adopted for pain relief during the first seven days of hospitalization in the Neonatal Intensive Care Unit and to identify the type and frequency of invasive procedures to which newborns are submitted. cross-sectional retrospective study. Out of the 188 hospitalizations occurred during the 12-month period, 171 were included in the study. The data were collected from the charts and the presence of pain was analyzed based on the Neonatal Infant Pain Scale and on nursing notes suggestions of pain. For statistical analysis, the Statistical Package for the Social Sciences was used, and the significance level was set at 5%. there was at least one record of pain in 50.3% of the hospitalizations, according to the pain scale adopted or nursing note. The newborns underwent a mean of 6.6 invasive procedures per day. Only 32.5% of the pain records resulted in the adoption of pharmacological or non-pharmacological intervention for pain relief. newborns are frequently exposed to pain and the low frequency of pharmacological or non-pharmacological interventions reinforces the undertreatment of this condition. determinar a frequência de dor e verificar as medidas realizadas para seu alívio durante os sete primeiros dias de internação na Unidade de Terapia Intensiva Neonatal, bem como identificar o tipo e frequência de procedimentos invasivos aos quais os recém-nascidos foram submetidos. estudo retrospectivo transversal. Das 188 internações ocorridas no período estipulado de 12 meses, 171 foram incluídas na pesquisa. Os dados foram coletados a partir dos prontuários e a presença de dor foi analisada tanto com base na escala de dor Neonatal Infant Pain Scale quanto mediante anotação de enfermagem sugestiva de dor. Para análise estatística, utilizou-se o programa Statistical Package for the Social Sciences, adotando-se nível de significância de 5%. em 50,3% das internações houve ao menos um registro de dor, conforme escala de dor adotada ou anotação de enfermagem. Os recém-nascidos foram submetidos à média de 6,6 procedimentos invasivos por dia. Apenas 32,5% dos registros de dor resultaram na adoção de condutas farmacológicas ou não farmacológicas para seu alívio. observa-se que os recém-nascidos são frequentemente expostos à dor e a baixa frequência de intervenções farmacológicas ou não farmacológicas reforça o subtratamento dessa condição. determinar la frecuencia del dolor, comprobar las medidas tomadas para su alivio durante los siete primeros días de internación en una Unidad de Terapia Intensiva Neonatal e identificar el tipo de procedimientos invasivos y la frecuencia a que se sometieron los recién nacidos. estudio retrospectivo transversal. De las 188 internaciones realizadas en el período estipulado de 12 meses, se incluyeron 171 en la investigación. Los datos se recolectaron a partir de los prontuarios; la presencia de dolor se analizó según la Escala de Valorización del Dolor en el Neonato (Neonatal Infant Pain Scale) y las notas de enfermería sobre el dolor. Para el análisis estadístico, se utilizó el programa 'Paquete estadístico para las ciencias sociales' (Statistical Package for the Social Sciences), adoptándose el nivel de significación del 5%. en el 50,3% de las internaciones hubo al menos un registro de dolor, según la escala de dolor adoptada o las notas de la enfermería. Se sometió a los recién nacidos a un promedio de 6,6 procedimientos invasivos por día. Sólo el 32,5% de los registros de dolor resultaron en la adopción de conductas farmacológicas o no farmacológicas para su alivio. se observa que los recién nacidos a menudo están expuestos al dolor, y la frecuencia baja de intervenciones farmacológicas o de las no farmacológicas refuerza el subtratamiento de dicha condición.

Preliminary study for small animal preclinical hadrontherapy facility

NASA Astrophysics Data System (ADS)

Russo, G.; Pisciotta, P.; Cirrone, G. A. P.; Romano, F.; Cammarata, F.; Marchese, V.; Forte, G. I.; Lamia, D.; Minafra, L.; Bravatá, V.; Acquaviva, R.; Gilardi, M. C.; Cuttone, G.

2017-02-01

Aim of this work is the study of the preliminary steps to perform a particle treatment of cancer cells inoculated in small animals and to realize a preclinical hadrontherapy facility. A well-defined dosimetric protocol was developed to explicate the steps needed in order to perform a precise proton irradiation in small animals and achieve a highly conformal dose into the target. A precise homemade positioning and holding system for small animals was designed and developed at INFN-LNS in Catania (Italy), where an accurate Monte Carlo simulation was developed, using Geant4 code to simulate the treatment in order to choose the best animal position and perform accurately all the necessary dosimetric evaluations. The Geant4 application can also be used to realize dosimetric studies and its peculiarity consists in the possibility to introduce the real target composition in the simulation using the DICOM micro-CT image. This application was fully validated comparing the results with the experimental measurements. The latter ones were performed at the CATANA (Centro di AdroTerapia e Applicazioni Nucleari Avanzate) facility at INFN-LNS by irradiating both PMMA and water solid phantom. Dosimetric measurements were performed using previously calibrated EBT3 Gafchromic films as a detector and the results were compared with the Geant4 simulation ones. In particular, two different types of dosimetric studies were performed: the first one involved irradiation of a phantom made up of water solid slabs where a layer of EBT3 was alternated with two different slabs in a sandwich configuration, in order to validate the dosimetric distribution. The second one involved irradiation of a PMMA phantom made up of a half hemisphere and some PMMA slabs in order to simulate a subcutaneous tumour configuration, normally used in preclinical studies. In order to evaluate the accordance between experimental and simulation results, two different statistical tests were made: Kolmogorov test and gamma index test. This work represents the first step towards the realization of a preclinical hadrontherapy facility at INFN-LNS in Catania for the future in vivo studies.

Measurement of the neutron fields produced by a 62 MeV proton beam on a PMMA phantom using extended range Bonner sphere spectrometers

NASA Astrophysics Data System (ADS)

Amgarou, K.; Bedogni, R.; Domingo, C.; Esposito, A.; Gentile, A.; Carinci, G.; Russo, S.

2011-10-01

The experimental characterization of the neutron fields produced as parasitic effect in medical accelerators is assuming an increased importance for either the patient protection or the facility design aspects. Medical accelerators are diverse in terms of particle type (electrons or hadrons) and energy, but the radiation fields around them have in common (provided that a given threshold energy is reached) the presence of neutrons with energy span over several orders of magnitude. Due to the large variability of neutron energy, field or dosimetry measurements in these workplaces are very complex, and in general, cannot be performed with ready-to-use commercial instruments. In spite of its poor energy resolution, the Bonner Sphere Spectrometer (BSS) is the only instrument able to simultaneously determine all spectral components in such workplaces. The energy range of this instrument is limited to E<20 MeV if only polyethylene spheres are used, but can be extended to hundreds of MeV by including metal-loaded spheres (extended range BSS, indicated with ERBSS). With the aim of providing useful data to the scientific community involved in neutron measurements at hadron therapy facilities, an ERBSS experiment was carried out at the Centro di AdroTerapia e Applicazioni Nucleari Avanzate (CATANA) of INFN—LNS (Laboratori Nazionali del Sud), where a proton beam routinely used for ophthalmic cancer treatments is available. The 62 MeV beam was directed towards a PMMA phantom, simulating the patient, and two neutron measurement points were established at 0° and 90° with respect to the beam-line. Here the ERBSS of UAB (Universidad Autónoma de Barcelona— Grup de Física de les Radiacions) and INFN (Istituto Nazionale di Fisica Nucleare—Laboratori Nazionali di Frascati) were exposed to characterize the "forward" and "sideward" proton-induced neutron fields. The use of two ERBSS characterized by different set of spheres, central detectors, and independently established and calibrated, is important for guaranteeing the robustness of the measured spectra and estimating their overall uncertainties.

[Not Available].

PubMed

MIján de la Torre, Alberto

2016-06-03

El síndrome de caquexia cancerosa es responsable de la muerte de un número significativo de pacientes con cáncer. Se caracteriza por la presencia de una ingesta reducida, con inflamación sistémica y un metabolismo alterado. Los enfermos presentan característicamente una progresiva pérdida de peso y de masa muscular, junto a deterioro funcional. La pérdida muscular se debe a la combinación de reducción de la síntesis proteica con aumento de su degradación. Ello conduce tanto a un acortamiento como a una reducción en el área de la fibra muscular. Asimismo, existen datos que apoyan que selectivamente algunos de los tipos de fibra muscular se ven más afectados. Es necesario definir bien los valores de corte de sarcopenia para diagnosticar la pérdida muscular y existen diferentes métodos. El sistema de la ubiquitina-proteasoma parece desempeñar un papel predominante en la degradación de la proteína miofibrilar. La tendencia a perder masa muscular en los pacientes con caquexia cancerosa parece estar asociada a la activación de señales catabólicas por citoquinas proinflamatorias, así como por productos tumorales del tipo factor inductor de proteólisis. En referencia a los factores pronósticos, el riesgo de muerte está bien documentado en pacientes con sarcopenia y, especialmente, en aquellos con obesidad asociada a la sarcopenia. Asimismo, se ha establecido una relación directa entre la pérdida intensa de masa muscular y la supervivencia en pacientes con diferentes tipos de tumores del tipo de cáncer de páncreas, pulmón, tracto biliar o cáncer colorrectal. Respecto de la terapia en el síndrome de caquexia cancerosa, es factible que requiera tratamiento con varios grupos combinados que incluyan, junto al soporte nutricional, fármacos orexígenos, con efecto anabólico y antinflamatorio, asociados a intervenciones que estimulen el ejercicio físico.

[Not Available].

PubMed

Baladia, Eduard; Frutos Pérez-Surio, Alberto; Martínez-Rodríguez, Rodrigo

2016-06-30

Objetivos: dar a conocer las recomendaciones relacionadas con la Nutrición Humana y Dietética (NHyD) de la Guía de Práctica Clínica para el manejo de la enfermedad de Parkinson del Sistema Nacional de Salud (GPC-EP/SNS) y favorecer su difusión e implementación en la práctica. El objetivo secundario es presentar la implicación de los profesionales de la NHyD en la elaboración de la guía.Material y métodos: siguiendo el Manual Metodológico de Elaboración de Guías de Práctica Clínica en el Sistema Nacional de Salud, se formularon las preguntas clínicas, se realizó una búsqueda sistemática para cada pregunta en bases de datos (PubMed/Medline, Embase, Cochrane Library, CRD, LILACS, IBECS y ClinicalTrials), se definieron los criterios de elegibilidad, al menos dos investigadores seleccionaron los estudios, se realizó lectura crítica de la literatura se resumió en tablas de síntesis de evidencia y se establecieron las recomendaciones.Resultados: se propusieron 14 preguntas relacionadas directamente con NHyD-Parkinson, de las cuales solamente 3 pudieron incluirse. Se formuló una pregunta relacionada con la terapia de logopedia aplicada en personas con EP que presentan problemas de deglución, tratamiento donde se imbrican los profesionales de la NHyD. De 642 artículos localizados, únicamente 2 pudieron ser incluidos para contestar las correspondientes preguntas. De las evidencias halladas, se derivaron 11 recomendaciones directa o indirectamente relacionados con la NHyD.Conclusiones: la implicación de profesionales sanitarios en equipos multidisciplinares mejora el resultado final de las guías y la atención sanitaria de los pacientes. Es necesario que los profesionales sanitarios de la NHyD (los/las dietistas-nutricionistas) se impliquen en iniciativas basadas en la mejor evidencia científica disponible y que formen parte de los equipos de trabajo multidisciplinares.

Cost of nursing most frequent procedures performed on severely burned patients.

PubMed

Melo, Talita de Oliveira; Lima, Antônio Fernandes Costa

2017-01-01

to identify the mean direct cost (MDC) of the most frequent procedures performed by nursing professionals on severely burned patients in an Intensive Care Unit. exploratory-descriptive quantitative single-case study. The MDC was calculated by multiplying time (timed) spent by nursing professionals in the performance of the procedures by the unit cost of direct labor, and adding the costs of material and medicine/solutions. a MDC of US$ 0.65 (SD=0.36) was obtained for "vital signs monitoring"; US$ 10.00 (SD=24.23) for "intravenous drug administration"; US$ 5.90 (SD=2.75) for "measurement of diuresis"; US$ 0.93 (SD=0.42) for "capillary blood glucose monitoring"; and US$ 99.75 (SD=129.55) for "bandaging". the knowledge developed can support managerial decision-making, contribute to the efficiency distribution of the resources involved and, when possible, provide cost-containment or cost-minimization strategies without impairing the quality of nursing care. identificar o custo direto médio (CDM) dos procedimentos realizados, com maior frequência, por profissionais de enfermagem, em uma Unidade de Terapia Intensiva, aos pacientes grandes queimados. pesquisa quantitativa, exploratório-descritiva, do tipo estudo de caso único. O CDM foi calculado multiplicando-se o tempo (cronometrado) despendido por profissionais de enfermagem na execução dos procedimentos, objeto de estudo, pelo custo unitário da mão de obra direta, somando-se ao custo dos materiais e soluções/medicamentos. obteve-se o CDM de US$ 0.65 (SD=0.36) para "controle dos sinais vitais"; US$ 10.00 (SD=24.23) para "administração de medicamentos via intravenosa"; US$ 5.90 (SD=2.75) para "mensuração de diurese"; US$ 0.93 (SD=0.42) para "verificação de glicemia capilar"; e US$ 99.75 (SD=129.55) para "curativo". o conhecimento desenvolvido pode fundamentar as tomadas de decisão gerenciais subsidiando a eficiência alocativa dos recursos envolvidos e, quando possível, indicar estratégias de contenção/minimização de custos sem prejuízos à qualidade da assistência de enfermagem.

Negative pressure therapy for the treatment of complex wounds.

PubMed

Lima, Renan Victor Kümpel Schmidt; Coltro, Pedro Soler; Farina, Jayme Adriano

2017-01-01

The objective of this study is to evaluate the effectiveness of negative pressure therapy (NPT) in the treatment of complex wounds, with emphasis on its mechanisms of action and main therapeutic indications. We searched the Pubmed / Medline database for articles published from 1997 to 2016, and selected the most relevant ones. The mechanisms of action of NPT involveboth physical effects, such as increased perfusion, control of edema and exudate, reduction of wound dimensions and bacterial clearance, and biological ones, such as the stimulation of granulation tissue formation, microdeformations and reduction of Inflammatory response. The main indications of NPT are complex wounds, such as pressure ulcers, traumatic wounds, operative wound dehiscences, burns, necrotizing wounds, venous ulcers, diabetic wounds, skin grafts, open abdomen, prevention of complications in closed incisions and in the association with instillation of solutions in infected wounds. RESUMO O objetivo desse estudo é avaliar a eficácia da terapia por pressão negativa (TPN) no tratamento de feridas complexas, com ênfase em seus mecanismos de ação e principais indicações terapêuticas. Foi realizada revisão na base de dados Pubmed / Medline, em artigos publicados de 1997 a 2016, e selecionados os mais relevantes. O mecanismo de ação da TPN envolve efeitos físicos, como o aumento da perfusão, controle do edema e do exsudato, redução das dimensões da ferida e depuração bacteriana, e biológicos, como o estímulo à formação de tecido de granulação, microdeformações e redução da resposta inflamatória local. As principais indicações da TPN são as feridas complexas como úlceras por pressão, feridas traumáticas, deiscências de ferida operatória, queimaduras, feridas necrotizantes, úlceras venosas, feridas diabéticas, os enxertos de pele, o abdome aberto, na prevenção de complicações em incisões fechadas e na associação com instilação de soluções em feridas infectadas.

Comprehensiveness and humanization of nursing care management in the Intensive Care Unit.

PubMed

Medeiros, Adriane Calvetti de; Siqueira, Hedi Crecencia Heckler de; Zamberlan, Claudia; Cecagno, Diana; Nunes, Simone Dos Santos; Thurow, Mara Regina Bergmann

2016-01-01

Identifying the elements that promote comprehensiveness and humanization of nursing care management in the Intensive Care Unit, with an ecosystemic approach. A documentary qualitative study. The method of documentary analysis was used for data analysis. Four pre-established categories were identified - Technical; Organizational; Technological; and Humanizing Dimensions. Data resulted in forming two sub-categories that integrate the humanizing dimension category, namely 'Comprehensiveness in healthcare actions' and 'Integrating processes and promoters of humanization,' bringing forth implications and challenges in forms of managing health work processes, enabling organizational, structural and managerial changes to the provided healthcare. It was considered that all structural elements in managing nursing care with a focus on the needs of users should be in line with public policies and the principles of comprehensiveness and humanization, thus possessing strong potential for transforming health practices. Identificar os elementos capazes de promover a integralidade e a humanização na gestão do cuidado de enfermagem na Unidade de Terapia Intensiva, com enfoque ecossistêmico. Pesquisa documental, de natureza qualitativa. Para a análise dos dados utilizou-se do método da análise documental. SForam identificadas quatro categorias preestabelecidas ‒ Dimensões: Técnica; Organizacional; Tecnológica e Humanizadora. Os dados resultantes das duas subcategorias que integraram a categoria Dimensão Humanizadora, Integralidade nas ações do cuidado e Processos integradores e promotores de humanização, trazem implicações e desafios nos modos de gerir os processos de trabalho em saúde, o que possibilita transformações organizacionais, estruturais e gerenciais na produção do cuidado. Considera-se que na gestão do cuidado de enfermagem todos os elementos estruturantes, com enfoque nas necessidades dos usuários, devem estar em consonância com as políticas públicas e os princípios da integralidade e da humanização e possuir forte potencial para a transformação das práticas em saúde.

Off-label use of rhBMP-2 as bone regeneration strategies in mandibular ameloblastoma unicystic.

PubMed

Silva, Henrique Celestino Lima E; Cheim, Adonai Peixoto; Moreno, Roberto; Miranda, Sérgio Luis de

2017-01-01

Jawbone reconstruction after tumor resection is one of the most challenging clinical tasks for maxillofacial surgeons. Osteogenic, osteoinductive, osteoconductive and non-antigenic properties of autogenous bone place this bone as the gold standard for solving problems of bone availability. However, the need for a second surgical site to harvest the bone graft increases significantly both the cost and the morbidity associated with the reconstructive procedures. Bone grafting gained an important tool with the discovery of bone morphogenetic proteins in 1960. Benefit of obtaining functional and real bone matrix without need of second surgical site seems to be the great advantage of use bone morphogenetic proteins. This study analyzed the use of rhBMP-2 in unicystic ameloblastoma of the mandible, detailing its structure, mechanisms of cell signaling and biological efficacy, in addition to present possible advantages and disadvantages of clinical use of rhBMP-2 as bone regeneration strategy. RESUMO A reconstrução óssea dos maxilares após ressecções tumorais é uma das tarefas mais difíceis para o cirurgião maxilofacial. As propriedades osteogênicas, osteoindutoras, osteocondutoras e não antigênicas do osso autógeno o colocam como o padrão-ouro para a solução de problemas de disponibilidade óssea. Entretanto a coleta do enxerto ósseo necessita de um segundo sítio cirúrgico, aumentando significativamente o custo e a morbidade associados ao procedimento reconstrutivo. A enxertia óssea ganhou uma excelente ferramenta com a descoberta das proteínas ósseas morfogenéticas na década de 1960. O benefício da obtenção de matriz óssea verdadeira e funcional, sem a necessidade de um segundo sítio cirúrgico, parece ser a grande vantagem do uso das proteínas ósseas morfogenéticas. Neste contexto, o objetivo deste estudo foi analisar a utilização da rhBMP-2 na regeneração óssea de ameloblastoma mandibular unicístico, detalhando sua estrutura, seus mecanismos de sinalização celular e sua eficácia biológica, além de apresentar potenciais vantagens e desvantagens da utilização clínica das rhBMP-2, enquanto estratégia regenerativa.

Characteristics of nursing professionals and the practice of ecologically sustainable actions in the medication processes.

PubMed

Furukawa, Patricia de Oliveira; Cunha, Isabel Cristina Kowal Olm; Pedreira, Mavilde da Luz Gonçalves; Marck, Patricia Beryl

2017-06-08

to verify the correlation between the characteristics of professionals and the practice of sustainable actions in the medication processes in an ICU, and to determine if interventions such as training and awareness can promote sustainable practices performed by nursing staff in the hospital. before-and-after design study using Lean Six Sigma methodology, applied in an intensive care unit. Nursing staff were observed regarding the practice of ecologically sustainable actions during medication processes (n = 324 cases for each group (pre and post-intervention)) through a data collection instrument. The processes analyzed involved 99 professionals in the pre-intervention phase and 97 in the post-intervention phase. Data were analyzed quantitatively and the association of variables was accomplished by means of statistical inference, according to the nature of the related variables. the education level was the only characteristic that showed to be relevant to an increase in sustainable practices, with a statistically significant difference (p = 0.002). When comparing before and after the intervention, there was an increase in environmentally friendly actions with statistically significant differences (p = 0.001). the results suggest that institutions should encourage and invest in formal education, as well as training of health professionals to promote sustainable practices in the hospital. verificar la correlación entre las características de los profesionales y la práctica de acciones sustentables en los procesos de medicación en una UTI y determinar si intervenciones como capacitación y concientización logran promover la práctica de acciones sustentables por el equipo de enfermería en el hospital. estudio antes y después usando la metodología Lean Seis Sigma, aplicada en una unidad de terapia intensiva. El equipo de enfermería fue observado referente a la práctica de acciones ecológicamente sustentables durante los procesos de medicación (n = 324 casos de cada grupo (pre y post-intervenciones) mediante un instrumento de recolecta de datos. Los procesos analizados involucraron 99 profesionales en la fase de post-intervención. Los datos fueron analizados cuantitativamente y para asociar las variables fue aplicada la estadística inferencial, según la naturaleza de las variables relacionadas. el nivel de escolaridad fue la única característica que se mostró relevante para el aumento de prácticas sustentables con diferencia estadísticamente significativa (p = 0,002). En la comparación antes y después de las intervenciones, aumentaron las acciones ecológicamente correctas con diferencia estadísticamente significante (p=0,001). los resultados sugieren que las instituciones deben estimular e invertir en la educación formal, y también en la capacitación de los profesionales de salud para la promoción de prácticas sustentables en los hospitales. verificar a correlação entre as características dos profissionais e a prática de ações sustentáveis nos processos de medicação em uma UTI e determinar se intervenções como treinamento e conscientização podem promover a prática de ações sustentáveis realizadas pela equipe de enfermagem no hospital. estudo antes e depois usando a metodologia Lean Seis Sigma aplicada em uma unidade de terapia intensiva. A equipe de enfermagem foi observada referente à prática de ações ecologicamente sustentáveis durante os processos de medicação (n = 324 casos de cada grupo (pré e pós-intervenções)) por meio de um instrumento de coleta de dados. Os processos analisados envolveram 99 professionais na fase de pré-intervenção e 97 na fase de pós-intervenção. Os dados foram analisados quantitativamente e a associação das variáveis foi realizada por meio de estatística inferencial, de acordo com a natureza das variáveis relacionadas. o nível de escolaridade foi a única característica que se mostrou relevante para o aumento de práticas sustentáveis com diferença estatisticamente significativa (p = 0,002). No comparativo antes e após as intervenções, houve um aumento das ações ecologicamente corretas com diferença estatisticamente significante (p=0,001). os resultados sugerem que as instituições devem estimular e investir na educação formal, assim como no treinamento dos profissionais de saúde para a promoção de práticas sustentáveis nos hospitais.

Pharmaceutical interventions in medications prescribed for administration via enteral tubes in a teaching hospital.

PubMed

Ferreira, Carolina Justus Buhrer; Plodek, Caroline Koga; Soares, Franciny Kossemba; Andrade, Rayza Assis de; Teleginski, Fernanda; Rocha, Maria Dagmar da

2016-01-01

to analyze the impact of guidelines regarding errors in medications prescribed for administration through enteral tubes. quantitative study, in three phases, undertaken in internal medicine, neurology and an intensive care unit in a general teaching hospital. In Phase 1, the following was undertaken: a protocol for dilution and unit-dose repackaging and administration for 294 medications via enteral tubes; a decision flowchart; operational-standard procedures for dilution and unit-dose repackaging of oral pharmaceutical forms and for administration of medications through enteral tubes. In phase 2, errors in 872 medications prescribed through enteral tubes, in 293 prescriptions for patients receiving inpatient treatment between March and June, were investigated. This was followed by training of the teams in relation to the guidelines established. In Phase 3, pharmaceutical errors and interventions in 945 medications prescribed through enteral tubes, in 292 prescriptions of patients receiving inpatient treatment between August and September, were investigated prospectively. The data collected, in a structured questionnaire, were compiled in the Microsoft Office Excel(r) program, and frequencies were calculated. 786 errors were observed, 63.9% (502) in Phase 2, and 36.1% (284) in Phase 3. In Phase 3, a reduction was ascertained in the frequency of prescription of medications delivered via enteral tubes, medications which were contraindicated, and those for which information was not available. guidelines and pharmaceutical interventions were determined in the prevention of errors involving medications delivered through enteral tubes. analisar o impacto de diretrizes sobre erros em medicamentos prescritos para administração via sondas enterais. estudo quantitativo, em três fases, realizado em clínica médica, neurologia e unidade de terapia intensiva de hospital geral universitário. Na Fase 1 elaborou-se: protocolo de diluição, unitarização - transformação e administração para 294 medicamentos via sondas enterais; fluxograma decisório; procedimentos operacionais-padrão de diluição e unitarização de formas farmacêuticas orais e de administração de medicamentos via sondas enterais. Na Fase 2 investigou-se, retrospectivamente, erros em 872 medicamentos prescritos via sondas enterais, em 293 prescrições de pacientes internados de março a junho. Seguiu-se capacitação das equipes sobre diretrizes estabelecidas. Na Fase 3 investigou-se, prospectivamente, erros e intervenções farmacêuticas em 945 medicamentos prescritos via sondas enterais, em 292 prescrições de pacientes internados de agosto a setembro. Dados coletados, em formulário estruturado, foram compilados no programa Microsoft Office Excel(r) e calculadas as frequências. foram observados 786 erros, 63,9% (502) na Fase 2 e 36,1% (284) na Fase 3. Na Fase 3 verificou-se redução na frequência de prescrição de medicamentos, via sondas enterais, contraindicados e sem informações disponíveis. diretrizes e intervenções farmacêuticas foram determinantes na prevenção dos erros de medicamentos via sondas enterais. analizar el impacto de directrices sobre errores en medicamentos prescritos para administración vía sondas enterales. estudio cuantitativo, en tres fases, realizado en una clínica médica-neurología y en unidad de terapia intensiva de un hospital general universitario. En la Fase 1 se elaboró: protocolo de dilución, reenvasado - transformación y administración para 294 medicamentos vía sondas enterales; diagrama de flujo de decisión; procedimientos operacionales estándar de dilución y reenvasado - transformación de formas farmacéuticas orales y de administración de medicamentos vía sondas enterales. En la Fase 2 se investigó, retrospectivamente, errores en 872 medicamentos prescritos vía sondas enterales, en 293 prescripciones de pacientes internados de marzo a junio. La continuación, capacitación de los equipos sobre directrices establecidas. En la Fase 3 se investigó, prospectivamente, errores e intervenciones farmacéuticas en 945 medicamentos prescritos vía sondas enterales, en 292 prescripciones de pacientes internados de agosto a septiembre. Datos fueron colectados en un formulario estructurado, compilados en el programa Microsoft Office Excel(r) y se calcularon las frecuencias. se observaron 786 errores, 63,9% (502) en la Fase 2 y 36,1% (284) en la Fase 3. En la Fase 3 se verificó una reducción en la frecuencia de prescripción de medicamentos, vía sondas enterales, contraindicados y sin informaciones disponibles. las directrices e intervenciones farmacéuticas fueron determinantes en la prevención de los errores de medicamentos vía sondas enterales.

Development and validation of educational technology for venous ulcer care.

PubMed

Benevides, Jéssica Lima; Coutinho, Janaina Fonseca Victor; Pascoal, Liliane Chagas; Joventino, Emanuella Silva; Martins, Mariana Cavalcante; Gubert, Fabiane do Amaral; Alves, Allana Mirella

2016-04-01

To develop and validate an educational technology venous ulcers care. Methodological study conducted in five steps: Situational diagnosis; literature review; development of texts, illustrations and layout; apparent and content validity by the Content Validity Index, assessment of Flesch Readability Index; and pilot testing. The developed technology was a type of booklet entitled Booklet for Venous Ulcers Care, consisting of seven topics: Diet and food intake, walking and light exercise, resting with elevated leg, bandage care, compression therapy, family support, and keeping healthy habits. The apparent validity revealed minimal agreement of 85.7% in the clarity and comprehensibility. The total content validity index was 0.97, the Flesch Readability Index was 75%, corresponding to the reading "fairly easy". The pilot test showed that 100% of people with venous ulcers evaluated the text and the illustrations as understandable, as appropriate. The educational technology proved to be valid for the appearance and content with potential for use in clinical practice. Construir e validar uma tecnologia educativa para cuidados com úlcera venosa. Estudo metodológico realizado em cinco fases: diagnóstico situacional; revisão da literatura; desenvolvimento de textos, ilustrações e diagramação; validade de aparência e de conteúdo pelo Índice de Validade de Conteúdo, avaliação do Índice de Legibilidade de Flesch; e teste piloto. A tecnologia desenvolvida foi do tipo cartilha intitulada Cartilha para cuidados com úlcera venosa, constituída de sete tópicos: Alimentação, Caminhadas e exercícios leves, Repouso com a perna elevada, Cuidados com o curativo, Terapia compressiva, Apoio familiar, e manter hábitos saudáveis. A validade aparente revelou concordância mínima de 85,7% na clareza e compreensibilidade. O Índice de Validade de Conteúdo total foi de 0,97, o Índice de legibilidade de Flesch foi de 75%, o que correspondeu à leitura "razoavelmente fácil". O teste piloto revelou que 100% das pessoas com úlcera venosa avaliaram o texto como compreensivo e as ilustrações, como adequadas. A tecnologia educativa mostrou-se válida quanto à aparência e ao conteúdo, com potencial de utilização na prática clínica.

Incidence and factors related to delirium in an intensive care unit.

PubMed

Mori, Satomi; Takeda, Juliana Rumy Tsuchihashi; Carrara, Fernanda Souza Angotti; Cohrs, Cibelli Rizzo; Zanei, Suely Sueko Viski; Whitaker, Iveth Yamaguchi

2016-01-01

To identify the incidence of delirium, compare the demographic and clinical characteristics of patients with and without delirium, and verify factors related to delirium in critical care patients. Prospective cohort with a sample made up of patients hospitalized in the Intensive Care Unit (ICU) of a university hospital. Demographic, clinical variables and evaluation with the Confusion Assessment Method for Intensive Care Unit to identify delirium were processed to the univariate analysis and logistic regression to identify factors related to the occurrence of delirium. Of the total 149 patients in the sample, 69 (46.3%) presented delirium during ICU stay, whose mean age, severity of illness and length of ICU stay were statistically higher. The factors related to delirium were: age, midazolam, morphine and propofol. Results showed high incidence of ICU delirium associated with older age, use of sedatives and analgesics, emphasizing the need for relevant nursing care to prevent and identify early, patients presenting these characteristics. Identificar a incidência de delirium, comparar as características demográficas e clínicas dos pacientes com e sem delirium e verificar os fatores relacionados ao delirium em pacientes internados em Unidade de Terapia Intensiva (UTI). Coorte prospectiva, cuja amostra foi constituída de pacientes internados em UTI de um hospital universitário. Variáveis demográficas, clínicas e da avaliação com o Confusion Assessment Method for Intensive Care Unit para identificação de delirium foram processadas para análise univariada, e regressão logística para identificar fatores relacionados à ocorrência do delirium. Do total de 149 pacientes da amostra, 69 (46,3%) apresentaram delirium durante a internação na UTI, observando-se que a média da idade, o índice de gravidade e o tempo de permanência nas UTI foram estatisticamente maiores. Os fatores relacionados ao delirium foram: idade, midazolam, morfina e propofol. Os resultados mostraram elevada incidência de delirium na UTI e sua ocorrência associada às idades mais avançadas e o uso de sedativos e analgésicos, ressaltando-se a importância da atuação do enfermeiro na prevenção e identificação precoce do quadro nos pacientes com essas características.

Prevalencia y factores de riesgo para infecciones del tracto urinario de inicio en la comunidad causadas por Escherichia coli productor de betalactamasas de espectro extendido en Colombia

PubMed Central

Blanco, Victor M.; Maya, Juan J.; Correa, Adriana; Perenguez, Marcela; Muñoz, Juan S.; Motoa, Gabriel; Pallares, Christian J.; Rosso, Fernando; Matta, Lorena; Celis, Yamile; Garzon, Martha; Villegas, y María V.

2016-01-01

RESUMEN Introducción Las infecciones del tracto urinario (ITU) son frecuentes en la comunidad. Sin embargo, la información de aislamientos resistentes en este contexto es limitada en Latinoamérica. Este estudio tiene como objetivo determinar la prevalencia y los factores de riesgo asociados con ITU de inicio en la comunidad (ITU-IC) causadas por Escherichia coli productor de betalactamasas de espectro extendido (BLEE) en Colombia. Materiales y métodos Entre agosto y diciembre de 2011 se realizó un estudio de casos y controles en 3 instituciones de salud de tercer nivel en Colombia. Se invitó a participar a todos los pacientes admitidos a urgencias con diagnóstico probable de ITU-IC, y se les pidió una muestra de orina. En los aislamien-tos de E. coli se realizaron pruebas confirmatorias para BLEE, susceptibilidad antibiótica, caracterización molecular (PCR en tiempo real para genes bla, repetitive element palindromic PCR [rep-PCR], multilocus sequence typing [MLST] y factores de virulencia por PCR). Se obtuvo información clínica y epidemiológica, y posteriormente se realizó el análisis estadístico. Resultados De los 2.124 pacientes seleccionados, 629 tuvieron un urocultivo positivo, en 431 de estos se aisló E. coli, 54 fueron positivos para BLEE y 29 correspondieron a CTX-M-15. La mayoría de los aislamientos de E. coli productor de BLEE fueron sensibles a ertapenem, fosfomicina y amikacina. La ITU complicada se asoció fuertemente con infecciones por E. coli productor de BLEE (OR = 3,89; IC 95%: 1,10–13,89; p = 0,03). E. coli productor de CTX-M-15 mostró 10 electroferotipos diferentes; de estos, el 65% correspondieron al ST131. La mayoría de estos aislamientos tuvieron 8 de los 9 factores de virulencia analizados. Discusión E. coli portador del gen blaCTX-M-15 asociado al ST131 sigue siendo frecuente en Colombia. La presencia de ITU-IC complicada aumenta el riesgo de tener E. coli productor de BLEE, lo cual debe tenerse en cuenta para ofrecer una terapia empírica adecuada. PMID:26774256

PubMed

De Abajo Larriba, Ana Beatriz; Díaz Rodríguez, Ángel; González-Gallego, Javier; Peleteiro Cobo, Beatriz; Capón Álvarez, Jessica; Mahmoud Atoui, Omar; Méndez Rodríguez, Enrique; De Abajo Olea, Serafín; Lumbreras González, Víctor; Minniti, Caterina

2016-09-20

Objetivos: estimar las actividades preventivas que realizan los pacientes diagnosticados de enfermedad pulmonar obstructiva crónica (EPOC) en la provincia de León.Métodos: estudio epidemiológico, transversal, multicéntrico (30 centros de salud de la provincia de León). Incluyó pacientes mayores de 35 años diagnosticados y tratados de EPOC. Variables a estudio: edad, sexo, hábitat, datos antropométricos, tabaquismo, estado nutricional, ejercicio físico, vacunación antigripal, vacunación, antineumocócica (VNP23 y VNC13), fenotipo, gravedad, reagudizaciones y hospitalizaciones. Los resultados se expresan con sus IC al 95,5%.Resultados: se incluyeron 833 pacientes, el 85,8% varones, edad media: 64,69 años (53,66-75,61) y 20,65 años (4,47-36,8) de evolución de la EPOC. El 86,67% (80,30-93,30) tenían antecedentes de tabaquismo (n = 722), de 35,26 años de evolución (17,87-52,64), consumían 28,36 paquetes al año (9,60-46,86), p < 0,001, siendo el 58% fumadores severos. En fumadores activos (n = 288) la intervención más efectiva fue terapia cognitivo-conductual más vareniclina, con abstinencias del 29,86%. En total dejaron de fumar el 51,05% (49,49-52,70) de los pacientes con EPOC, p < 0,001. El 73,67% (71,78-75,65) realizaba ejercicio prescrito, el 88,76% (84,82-90,7) realizaba dieta equilibrada, el 89,7% (87,8-91,8) estaba vacunado frente a la gripe, siendo esta más frecuente en los mayores de 65 años y hospitalizados, p < 0,001. El 9,61% (7,7-11,6) de los no vacunados tuvo reagudizaciones que requirieron ingreso hospitalario, p < 0,001. La tasa de vacunación con VNP23 fue del 52,8% (49,3-56,4) vs.4,97% (3,0-6,61) de VNC13, p < 0,05.Conclusiones: las actividades preventivas en los pacientes con EPOC se realizan de forma óptima en nuestro entorno, superior a la media nacional, aunque se deben lograr mayores tasas de cobertura de vacunación frente al neumococo.

Nursing workload and occurrence of adverse events in intensive care: a systematic review.

PubMed

Oliveira, Andrea Carvalho de; Garcia, Paulo Carlos; Nogueira, Lilia de Souza

2016-01-01

To identifyevidences of the influence of nursing workload on the occurrence of adverse events (AE) in adult patients admitted to the intensive care unit (ICU). A systematic literature review was conducted in the databases MEDLINE, CINAHL, LILACS, SciELO, BDENF, and Cochrane from studies in English, Portuguese, or Spanish, published by 2015. The analyzed AE were infection, pressure ulcer (PU), patient falls, and medication errors. Of 594 potential studies, eight comprised the final sample of the review. TheNursing Activities Score (NAS; 37.5%) and the Therapeutic Intervention Scoring System(TISS; 37.5%) were the instruments most frequently used for assessing nursing workload. Six studies (75.0%) identified the influence of work overload in events of infection, PU, and medicationerrors. An investigation found that the NAS was a protective factor for PU. The nursing workload required by patients in the ICU influenced the occurrence of AE, and nurses must monitor this variable daily to ensure proper sizing of staff and safety of care. Identificar evidências sobre a influência da carga de trabalho de enfermagem na ocorrência de eventos adversos (EA) em pacientes adultos internados em Unidade de Terapia Intensiva (UTI). Revisão sistemática da literatura realizada nas bases de dados MEDLINE, CINAHL, LILACS, SciELO, BDENF e Cochrane deestudosem inglês, português ou espanhol, publicados até 2015. Os EA analisados foram infecção, úlcera por pressão (UPP), quedas e erros associados a medicamentos. Das 594 pesquisas potenciais identificadas, oito compuseram a amostra final da revisão. O NursingActivities Score -NAS (37,5%) e o TherapeuticInterventionScoring System -TISS (37,5%) foram os instrumentos mais utilizados para avaliação da carga de trabalho de enfermagem. Seis pesquisas (75,0%) identificaram influência da sobrecarga de trabalho na ocorrência de infecção, UPP e uso de medicamentos. Uma investigação identificou que o NAS foi fator de proteção para UPP. A carga de trabalho de enfermagem requerida por pacientes na UTI influenciou a ocorrência de EA, e os enfermeiros devem monitorar diariamente esta variável para garantir o correto dimensionamento da equipe e a segurança da assistência prestada.

Biofunctionality and immunocompatibility of starch-based biomaterials

NASA Astrophysics Data System (ADS)

Marques, Alexandra Margarida Pinto

A procura de novos biomateriais que desempenhem funcoes especificas sem, no entanto, desencadearem respostas negativas nos hospedeiros constitui um desafio permanente e actual nesta area. Biomateriais degradaveis foram uma das solucoes propostas e actualmente em aplicacao mas, embora possuam vantagens inegaveis, tambem apresentam alguns problemas nomeadamente no que diz respeito aos seus produtos de degradacao e respectivos efeitos negativos consequentes. Outros biomateriais, entre os quais polimeros de origem natural, foram propostos considerando que os seus produtos de degradacao poderao ser incorporados nas vias metabolicas normais evitando efeitos secundarios no hospedeiro. Ate ao momento, e apesar de todos os esforcos e do grande numero de dispositivos biomedicos desenvolvidos, o biomaterial ideal para uma aplicacao especifica ainda nao foi encontrado. Estudos com polimeros biodegradaveis a base de amido demonstraram que estes materiais possuem propriedades promissoras abrindo novas perspectivas para a sua possivel aplicacao numa variedade de aplicacoes biomedicas. Assim, de modo a demonstrar que estes materiais tem de facto potencial para serem utilizados em, por exemplo, substituicao ossea, sistemas de libertacao controlada, cimentos osseos e engenharia de tecidos, seria imperativo avaliar com maior profundidade a resposta biologica desencadeada pelos mesmos. Para tal foi delineado um plano de trabalhos com tres objectivos principais: i) avaliar a citocompatibilidade dos polimeros e compositos a base de amido com monitorizacao da citotoxicidade e analise da adesao e proliferacao celulares nas suas superficies. Foi dada particular atencao a osteoblastos considerando uma possivel aplicacao ortopedica para estes materiais; ii) estabelecer modelos in vitro para analisar e prever, tanto quanto possivel, uma situacao real de resposta inflamatoria; iii) validar os resultados in vitro com um modelo in vivo ja estabelecido em outros trabalhos de analise da resposta inflamatoria a biomateriais. Em resumo, os estudos de citocompatibilidade e imunocompatibilidade demonstraram que os polimeros e compositos a base de milho sao biomateriais promissores. Em comparacao com os biomateriais degradaveis actualmente em uso, possuem propriedades capazes de induzir um comportamento semelhante, ou mesmo melhor, em termos de citotoxicidade. Estes dados foram reconfirmados com a adesao e proliferacao de celulas do tipo osteoblastos na superficie de alguns dos materiais a base de amido, que demonstraram ser comparaveis as observadas no PLLA, evidenciando a possibilidade de usar esses materiais em aplicacoes ortopedicas. As conclusoes retiradas dos estudos in vitro e in vivo de imunocompatibilidade reforcam as observacoes das experiencias de citocompatibilidade e em conjunto, evidenciam a possibilidade de utilizacao dos biomateriais a base de amido, com fraca capacidade de desencadear uma reaccao inflamatoria, em aplicacoes biomedicas. (Abstract shortened by ProQuest.).

Collective Behaviors in Spatially Extended Systems with Local Interactions and Synchronous Updating

NASA Astrophysics Data System (ADS)

ChatÉ, H.; Manneville, P.

1992-01-01

Assessing the extent to which dynamical systems with many degrees of freedom can be described within a thermodynamics formalism is a problem that currently attracts much attention. In this context, synchronously updated regular lattices of identical, chaotic elements with local interactions are promising models for which statistical mechanics may be hoped to provide some insights. This article presents a large class of cellular automata rules and coupled map lattices of the above type in space dimensions d = 2 to 6.Such simple models can be approached by a mean-field approximation which usually reduces the dynamics to that of a map governing the evolution of some extensive density. While this approximation is exact in the d = infty limit, where macroscopic variables must display the time-dependent behavior of the mean-field map, basic intuition from equilibrium statistical mechanics rules out any such behavior in a low-dimensional systems, since it would involve the collective motion of locally disordered elements.The models studied are chosen to be as close as possible to mean-field conditions, i.e., rather high space dimension, large connectivity, and equal-weight coupling between sites. While the mean-field evolution is never observed, a new type of non-trivial collective behavior is found, at odds with the predictions of equilibrium statistical mechanics. Both in the cellular automata models and in the coupled map lattices, macroscopic variables frequently display a non-transient, time-dependent, low-dimensional dynamics emerging out of local disorder. Striking examples are period 3 cycles in two-state cellular automata and a Hopf bifurcation for a d = 5 lattice of coupled logistic maps. An extensive account of the phenomenology is given, including a catalog of behaviors, classification tables for the celular automata rules, and bifurcation diagrams for the coupled map lattices.The observed underlying dynamics is accompanied by an intrinsic quasi-Gaussian noise (stemming from the local disorder) which disappears in the infinite-size limit. The collective behaviors constitute a robust phenomenon, resisting external noise, small changes in the local dynamics, and modifications of the initial and boundary conditions. Synchronous updating, high space dimension and the regularity of connections are shown to be crucial ingredients in the subtle build-up of correlations giving rise to the collective motion. The discussion stresses the need for a theoretical understanding that neither equilibrium statistical mechanics nor higher-order mean-field approximations are able to provide.

Transection of the hepatic parenchyma associated or not with the contralateral portal vein branch ligature and its effect in liver regeneration.

PubMed

Wiederkehr, Henrique de Aguiar; Wiederkehr, Julio Cesar; Collaço, Luiz Martins; Sousa, Eros Luiz de; Salvalaggio, Paolo; Carvalho, Caroline Aragão de; Wiederkehr, Barbara de Aguiar; Marques, Camila Aparecida Moraes; Rosa, Francielle França da; Nanni, Felipe de Negreiros; Fuchs, Taíse

2017-01-01

To analyze the influence of portal vein ligation in hepatic regeneration by immunohistochemical criteria. Ten pigs divided into two groups of five animals underwent hepatectomy in two stages, and the groups were differentiated by ligation or not of the left portal vein tributary, which is responsible for vascularization of the left lateral and medial lobes of the pig liver. Five days after the procedure, the animals underwent liver biopsies for further analysis of histological and immunohistochemical with marker Ki67. The group submitted to hepatectomy with vascular ligation showed an increase of approximately 4% of hepatocytes in regeneration status, as well as a greater presence of Kupffer and inflammatory cells as compared to control. As a result of positive cell replication observed through the Ki67 marker, we can suspect that the ligation of a tributary of the portal vein associated with liver resection promoted a greater stimulus of liver regeneration when compared to liver resection alone. Analisar a influência da ligadura da tributária da veia porta no estímulo regenerativo hepático por meio de critérios imuno-histoquímicos. Dez suínos, divididos em dois grupos de cinco animais, foram submetidos à hepatectomia em dois estágios, sendo que os grupos foram diferenciados pela ligadura ou não da tributária da veia porta, responsável pela vascularização dos lobos lateral e medial esquerdos do fígado do suíno. Cinco dias após o procedimento, os animais foram reabordados para retirada de amostras hepáticas para posterior análise de histológica e imunoistoquímica com o marcador Ki67. O grupo submetido à hepatectomia com ligadura vascular apresentou incremento de 4% aproximadamente de hepatócitos em processo de regeneração, bem como grande número de células de Kupffer e células inflamatórias, quando comparado ao controle. Em virtude da análise positiva da replicação celular observada por meio do marcador Ki67, pode-se observar que a ligadura de uma tributária da veia porta promoveu um maior estímulo de regeneração hepática, efeito observado com menor intensidade no grupo submetido apenas à ressecção hepática.

Concepciones Alternativas de "Fotosintesis" en estudiantes Universitarios del curso basico de Biologia y posibles correcciones con el Modelo Educativo MODEF

NASA Astrophysics Data System (ADS)

De Jesus Roman, Sandra

Concepciones Alternativas de Fotosíntesis en estudiantes Universitariosdel curso básico de Biología y posibles correcciones con el Modelo Educativo MODEF El modelo educativo para la enseñanza de Fotosíntesis (MODEF) se implantó para trabajar el problema de las concepciones alternativas (CA) en un curso de Biología General. Se evaluaron los resultados en cuanto al logro del aprendizaje significativo. La pregunta central de la investigación fue: ¿Cómo aporta el modelo educativo en la didáctica y comprensión del tema de fotosíntesis? Se efectuó una investigación acción con una fase cuantitativa y una cualitativa. Para la fase cuantitativa se elaboró una prueba para determinar las concepciones alternativas, se validó y se sometió a los estudiantes que participaron en el estudio antes y después de ofrecer la unidad de metabolismo celular. Los participantes eran estudiantes de primer año de la Universidad de Puerto Rico en Bayamón (UPRB). Se llevó a cabo un análisis de consistencia interna de la prueba mediante el método Alfa de Cronbach. Se analizaron las contestaciones a cada pregunta mediante la prueba de Ji cuadrado de contingencia, se efectuó la prueba de t y el coeficiente r de Pearson. La fase cualitativa incluyó la observación participativa de la investigadora- profesora, las reflexiones de los estudiantes y la información de las entrevistas semi-estructuradas que se realizaron a tres estudiantes del curso. El análisis se llevó a cabo mediante el Modelo de Wolcott. Se trabajaron diez CA de las cuales siete fueron corregidas mediante el Modelo MODEF. Las actividades más importantes para el proceso de aprendizaje incluyeron el trabajo de investigación o búsqueda de información para hacer una presentación digital, la elaboración de tablas, los mapas de conceptos, el uso de visuales o videos y las analogías para explicar conceptos o procesos. En conclusión: se recomienda el uso del Modelo MODEF para la discusión del tema de Fotosíntesis a base de los resultados cuantitativos y cualitativos de esta investigación. El Comité Institucional para la Protección de los Seres Humanos en la Investigación (CIPSHI) autorizó el estudio.

9 CFR 94.8 - Pork and pork products from regions where African swine fever exists or is reasonably believed to...

Code of Federal Regulations, 2012 CFR

2012-01-01

... where African swine fever exists or is reasonably believed to exist. 94.8 Section 94.8 Animals and... NEWCASTLE DISEASE, AFRICAN SWINE FEVER, CLASSICAL SWINE FEVER, SWINE VESICULAR DISEASE, AND BOVINE... where African swine fever exists or is reasonably believed to exist. African swine fever exists or the...

Immunological failure of first-line and switch to second-line antiretroviral therapy among HIV-infected persons in Tanzania: analysis of routinely collected national data

PubMed Central

Vanobberghen, Fiona M; Kilama, Bonita; Wringe, Alison; Ramadhani, Angela; Zaba, Basia; Mmbando, Donan; Todd, Jim

2015-01-01

Objectives Rates of first-line treatment failure and switches to second-line therapy are key indicators for national HIV programmes. We assessed immunological treatment failure defined by WHO criteria in the Tanzanian national HIV programme. Methods We included adults initiating first-line therapy in 2004–2011 with a pre-treatment CD4 count, and ≥6-months of follow-up. We assessed subhazard ratios (SHR) for immunological treatment failure, and subsequent switch to second-line therapy, using competing risks methods to account for deaths. Results Of 121 308 adults, 7% experienced immunological treatment failure, and 2% died without observed immunological treatment failure, over a median 1.7 years. The 6-year cumulative probability of immunological treatment failure was 19.0% (95% CI 18.5, 19.7) and of death, 5.1% (4.8, 5.4). Immunological treatment failure predictors included earlier year of treatment initiation (P < 0.001), initiation in lower level facilities (SHR = 2.23 [2.03, 2.45] for dispensaries vs. hospitals), being male (1.27 [1.19, 1.33]) and initiation at low or high CD4 counts (for example, 1.78 [1.65, 1.92] and 5.33 [4.65, 6.10] for <50 and ≥500 vs. 200–349 cells/mm3, respectively). Of 7382 participants in the time-to-switch analysis, 6% switched and 5% died before switching. Four years after immunological treatment failure, the cumulative probability of switching was 7.3% (6.6, 8.0) and of death, 6.8% (6.0, 7.6). Those who immunologically failed in dispensaries, health centres and government facilities were least likely to switch. Conclusions Immunological treatment failure rates and unmet need for second-line therapy are high in Tanzania; virological monitoring, at least for persons with immunological treatment failure, is required to minimise unnecessary switches to second-line therapy. Lower level government health facilities need more support to reduce treatment failure rates and improve second-line therapy uptake to sustain the benefits of increased coverage. Objectifs Les taux d’échec du traitement de 1ère ligne et les passages au traitement de 2nde ligne sont des indicateurs clés pour les programmes nationaux VIH. Nous avons évalué l’échec immunologique du traitement selon les critères de l’OMS dans le programme national VIH tanzanien. Méthodes Nous avons inclus les adultes entreprenant une thérapie de 1ère ligne entre 2004 et 2011 avec une numération des CD4 prétraitement disponible et un suivi ≥6 mois. Nous avons évalué les rapports en dessous du risque pour l’échec immunologique du traitement et le passage subséquent à la thérapie de 2nde ligne, en utilisant les méthodes de risques concurrents pour tenir compte des décès. Résultats Sur 121.308 adultes, 7% ont connu un échec immunologique du traitement et 2% sont décédés sans observation d’échec immunologique du traitement, sur une médiane de 1,7 ans. La probabilité cumulée d’échec immunologique du traitement sur six ans était de 19,0% (IC95%: 18,5 à 19,7) et 5,1% (4,8 à 5,4) de décès. Les prédicteurs d’échecs immunologiques du traitement comprenaient: l'instauration précoce du traitement (p <0,001), l'initiation dans les établissements de niveau inférieur (SHR = 2,23 [2,03 à 2,45] pour les dispensaires versus les hôpitaux), le sexe masculin (1,27 [1,19 à 1,33]) et l'initiation du traitement à des taux de CD4 faibles ou élevés (par exemple, 1,78 [1,65 à 1,92] et 5,33 [4,65 à 6,10] pour des taux <50 et ≥500 versus des taux compris entre 200 et 349 cellules/mm3, respectivement). Sur 7.382 participants à l'analyse sur le moment du changement de traitement, 6% ont changé de traitement et 5% sont décédés avant le changement. Quatre ans après l’échec immunologique du traitement, la probabilité cumulative du changement de traitement était de 7,3% (6,6 à 8,0) et de 6,8% (6,0 à 7,6) pour les décès. Ceux qui ont connu un échec immunologique dans les dispensaires, les centres de santé et les établissements gouvernementaux étaient les moins susceptibles de changer de traitement. Conclusions Les taux d’échecs immunologiques du traitement et les besoins non satisfaits pour le traitement de 2nde ligne sont élevés en Tanzanie. La surveillance virologique, au moins pour les personnes avec un échec immunologique de traitement, est nécessaire pour minimiser les passages inutiles au traitement de 2nde ligne. Les établissements de santé gouvernementaux de niveau inférieur ont besoin de plus de support pour réduire les taux d’échec de traitement et pour améliorer l'adoption de la thérapie de 2nde ligne afin de maintenir les avantages d'une couverture accrue. Objetivos Las tasas de fallo de la terapia de primera línea y los cambios a la terapia de segunda línea son indicadores claves para los programas nacionales de VIH. Hemos evaluado los fallos en el tratamiento inmunológico definidos según criterios de la OMS dentro del programa nacional para VIH en Tanzania. Métodos Hemos incluido adultos que iniciaban la terapia de primera línea entre el 2004-2011 con un conteo de CD4 antes de recibir el tratamiento, y tras ≥6 meses de seguimiento. Hemos evaluado los subíndices de riesgo del fallo inmunológico en el tratamiento, y el cambio subsecuente a la segunda línea de tratamiento, utilizando análisis de riesgo competitivo para explicar las muertes. Resultados De 121,308 adultos, un 7% experimentó fallo inmunológico, y un 2% murió sin observarse un fallo inmunológico en el tratamiento, a lo largo de una mediana de 1.7 años. La probabilidad acumulada a lo largo de seis años de fallo terapéutico inmunológico era del 19.0% (IC 95% 18.5, 19.7) y de muerte del 5.1% (4.8,5.4). Los vaticinadores de fallo terapéutico inmunológico incluían haber empezado el tratamiento un año antes (p<0.001), haberlo iniciado en centros de menor nivel (SHR=2.23 [2.03,2.45] para dispensarios versus hospitales), ser ombre (1.27 [1.19,1.33]) e iniciar con conteos de CD$ bajos o altos (por ejemplo, 1.78 [1.65,1.92] y 5.33 [4.65,6.10] para <50 y ≥500 versus 200-349 células/mm3, respectivamente). De 7,382 participantes en el análisis de tiempo-hasta-el-cambio, un 6% cambió y un 5% murió antes del cambio. Cuatro años después del fallo terapéutico inmunológico, la probabilidad acumulativa de cambiar era del 7.3% (6.6,8.0) y de muerte, del 6.8% (6.0,7.6). Aquellos que tuvieron un fallo terapéutico inmunológico en los dispensarios, centros sanitarios y centros gubernamentales tenían una menor probabilidad de cambiar. Conclusiones Las tasas de fallo terapéutico inmunológico y una necesidad de segunda línea de tratamiento no resuelta son altas en Tanzania; la monitorización virológica, al menos en el caso de personas con fallo terapéutico inmunológico, es necesaria para minimizar los cambios innecesarios a la segunda línea de tratamiento. Los centros sanitarios gubernamentales de menor nivel requieren de más apoyo para reducir las tasas de fallo terapéutico y mejorar la aceptación de la segunda línea de tratamiento asegurando la continuidad de los beneficios de una mayor cobertura. PMID:25779383

Acute Pancreatitis as a Model to Predict Transition of Systemic Inflammation to Organ Failure in Trauma and Critical Illiness

DTIC Science & Technology

2016-10-01

P re-existing liver disease -  P re-existing im m une deficiency -  P re-existing pulm onary disease -  P re-existing cardiovascular disease ...liver disease - P re-existing im m une deficiency - P re-existing pulm onary disease - P re-existing cardiovascular disease - P ancreatic cancer and...correctly model disease course thereby aiding in treatment of patients. In this report, we analyzed the serum samples for proteins that will help to

40 CFR 165.87 - Design and capacity requirements for existing structures.

Code of Federal Regulations, 2013 CFR

2013-07-01

... existing containment structure: (1) The containment structure must be constructed of steel, reinforced... existing structures. 165.87 Section 165.87 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Structures § 165.87 Design and capacity requirements for existing structures. (a) For all existing...

40 CFR 165.87 - Design and capacity requirements for existing structures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... existing containment structure: (1) The containment structure must be constructed of steel, reinforced... existing structures. 165.87 Section 165.87 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Structures § 165.87 Design and capacity requirements for existing structures. (a) For all existing...

40 CFR 165.87 - Design and capacity requirements for existing structures.

Code of Federal Regulations, 2012 CFR

2012-07-01

... existing containment structure: (1) The containment structure must be constructed of steel, reinforced... existing structures. 165.87 Section 165.87 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Structures § 165.87 Design and capacity requirements for existing structures. (a) For all existing...

40 CFR 165.87 - Design and capacity requirements for existing structures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... existing containment structure: (1) The containment structure must be constructed of steel, reinforced... existing structures. 165.87 Section 165.87 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Structures § 165.87 Design and capacity requirements for existing structures. (a) For all existing...

49 CFR 451.7 - Alternative approval of existing containers.

Code of Federal Regulations, 2013 CFR

2013-10-01

..., DEPARTMENT OF HOMELAND SECURITY SAFETY APPROVAL OF CARGO CONTAINERS TESTING AND APPROVAL OF CONTAINERS Approval of Existing Containers § 451.7 Alternative approval of existing containers. (a) Existing... 49 Transportation 6 2013-10-01 2013-10-01 false Alternative approval of existing containers. 451.7...

49 CFR 451.7 - Alternative approval of existing containers.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., DEPARTMENT OF HOMELAND SECURITY SAFETY APPROVAL OF CARGO CONTAINERS TESTING AND APPROVAL OF CONTAINERS Approval of Existing Containers § 451.7 Alternative approval of existing containers. (a) Existing... 49 Transportation 6 2011-10-01 2011-10-01 false Alternative approval of existing containers. 451.7...

49 CFR 451.7 - Alternative approval of existing containers.

Code of Federal Regulations, 2012 CFR

2012-10-01

..., DEPARTMENT OF HOMELAND SECURITY SAFETY APPROVAL OF CARGO CONTAINERS TESTING AND APPROVAL OF CONTAINERS Approval of Existing Containers § 451.7 Alternative approval of existing containers. (a) Existing... 49 Transportation 6 2012-10-01 2012-10-01 false Alternative approval of existing containers. 451.7...

49 CFR 451.7 - Alternative approval of existing containers.

Code of Federal Regulations, 2014 CFR

2014-10-01

..., DEPARTMENT OF HOMELAND SECURITY SAFETY APPROVAL OF CARGO CONTAINERS TESTING AND APPROVAL OF CONTAINERS Approval of Existing Containers § 451.7 Alternative approval of existing containers. (a) Existing... 49 Transportation 6 2014-10-01 2014-10-01 false Alternative approval of existing containers. 451.7...

49 CFR 451.7 - Alternative approval of existing containers.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., DEPARTMENT OF HOMELAND SECURITY SAFETY APPROVAL OF CARGO CONTAINERS TESTING AND APPROVAL OF CONTAINERS Approval of Existing Containers § 451.7 Alternative approval of existing containers. (a) Existing... 49 Transportation 6 2010-10-01 2010-10-01 false Alternative approval of existing containers. 451.7...

10 CFR 4.127 - Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 1 2010-01-01 2010-01-01 false Existing facilities. 4.127 Section 4.127 Energy NUCLEAR... 1973, as Amended Discriminatory Practices § 4.127 Existing facilities. (a) Accessibility. A recipient... make each of its existing facilities or every part of an existing facility accessible to and usable by...

Existence conditions for unknown input functional observers

NASA Astrophysics Data System (ADS)

Fernando, T.; MacDougall, S.; Sreeram, V.; Trinh, H.

2013-01-01

This article presents necessary and sufficient conditions for the existence and design of an unknown input Functional observer. The existence of the observer can be verified by computing a nullspace of a known matrix and testing some matrix rank conditions. The existence of the observer does not require the satisfaction of the observer matching condition (i.e. Equation (16) in Hou and Muller 1992, 'Design of Observers for Linear Systems with Unknown Inputs', IEEE Transactions on Automatic Control, 37, 871-875), is not limited to estimating scalar functionals and allows for arbitrary pole placement. The proposed observer always exists when a state observer exists for the unknown input system, and furthermore, the proposed observer can exist even in some instances when an unknown input state observer does not exist.

46 CFR 50.05-5 - Existing boilers, pressure vessels or piping systems.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 2 2010-10-01 2010-10-01 false Existing boilers, pressure vessels or piping systems. 50... ENGINEERING GENERAL PROVISIONS Application § 50.05-5 Existing boilers, pressure vessels or piping systems. (a) Whenever doubt exists as to the safety of an existing boiler, pressure vessel, or piping system, the marine...

Robotic tele-existence

NASA Technical Reports Server (NTRS)

Tachi, Susumu; Arai, Hirohiko; Maeda, Taro

1989-01-01

Tele-existence is an advanced type of teleoperation system that enables a human operator at the controls to perform remote manipulation tasks dexterously with the feeling that he or she exists in the remote anthropomorphic robot in the remote environment. The concept of a tele-existence is presented, the principle of the tele-existence display method is explained, some of the prototype systems are described, and its space application is discussed.

Use of a severity indicator as a predictor of the use of hepatic transplantation resources.

PubMed

Eiras, Flavia Regina Cocuzza das; Barbosa, Antonio Pires; Leão, Eliseth Ribeiro; Biancolino, César Augusto

2016-01-01

To evaluate the use of a severity indicator for end-stage liver disease as a predictor of resource use in a teaching hospital in São Paulo. Descriptive, retrospective study, classifying independent variables in seven key dimensions: identification/risk rating; length of stay/use of advanced life support; imaging; clinical analysis; special procedures; blood products in the intensive care unit; and in the operating room. The frequencies were analyzed by linear regression analysis of variance to detect relevance due to the dependent variable (severity indicator) in 76 cases seen in 2013. Among the variables studied, those that presented relevance due to the functional risk score were laboratory measurements of bilirubin, amylase, transaminase, blood count, creatine phosphokinase (p<0.05), hemotherapy procedures fresh frozen plasma (FFP) and platelet concentrate (p<0.05), and Doppler echocardiography image (p<0.07). Given the results/objective of this study, it is concluded that the indicator presents a potential predictive capability in the use of postoperative resources of liver receptors in the size, clinical analysis, images and hemotherapy dimensions. Avaliar o uso do indicador de gravidade para doenças hepáticas terminais como fator preditivo do uso de recursos em um hospital-escola de São Paulo. Estudo descritivo, retrospectivo, classificando variáveis independentes em sete dimensões principais: identificação/classificação de risco; tempo de permanência/uso de suporte avançado à vida; exames de imagem; análises clínicas; procedimentos especiais; hemoderivados em unidade de terapia intensiva; e em centro cirúrgico. As frequências foram analisadas por regressão linear com análise de variância para detecção de relevâncias face à variável dependente (indicador de gravidade) em 76 casos atendidos em 2013. Dentre as variáveis estudadas, apresentaram relevância em função do escore de risco funcional as dosagens laboratoriais de bilirrubina, amilase, transaminase, hemograma, creatinofosfoquinase (p<0,05), procedimentos hemoterápicos plasma fresco congelado (PFC) e concentrado de plaquetas (p<0,05), e imagem Ecodoppler (p<0,07). Face aos resultados/propósito do estudo conclui-se que o indicador apresenta potencial capacidade preditiva no uso de recursos pós-operatórios de receptores de fígado nas dimensões, análises clínicas, imagens e hemoterapia.

Medicina integrativa en América: De qué forma se está practicando la medicina integrativa en los centros clínicos en los Estados Unidos

PubMed Central

Horrigan, Bonnie; Lewis, Sheldon; Abrams, Donald I.; Pechura, Constance

2012-01-01

RESUMEN EJECUTIVO El impulso para desarrollar e implementar estrategias de medicina integrativa está enraizado en el deseo de mejorar la atención al paciente. The Bravewell Collaborative, una organización sin ánimo de lucro dedicada a la mejora de la atención sanitaria, define la medicina integrativa como “un enfoque de la medicina que coloca al paciente en el centro y se dirige al conjunto completo de influencias físicas, emocionales, mentales, sociales, espirituales y ambientales que afectan a la salud de la persona. Con una estrategia personalizada que considera las condiciones, necesidades y circunstancias únicas del paciente, utiliza las intervenciones más apropiadas de una variedad de disciplinas científicas para curar la afección y la enfermedad y ayudar a las personas a recobrar y mantener una salud óptima”. En las pasadas dos décadas, se ha documentado un número creciente de centros clínicos que proporcionan medicina integrativa, el número de facultades y escuelas médicas que enseñan estrategias integrativas, el número de investigadores que estudian intervenciones integrativas, y el número de pacientes que solicitan cuidados integrativos. Pero se desconocía si la medicina integrativa se estaba ofreciendo de manera igual, similar, o dispar. Además, mientras que los estudios anteriores se centraban en la prevalencia y el uso de la medicina complementaria o alternativa (MCA) por parte de los pacientes1,2 o de los médicos en hospitales3, enumerando la utilización de terapias MCA individuales, se había recogido muy poca información con respecto a la práctica real de la medicina integrativa que, por definición, trata a la persona en su conjunto. En 2011, The Bravewell Collaborative encargó una encuesta para determinar la forma en que la medicina integrativa se estaba practicando en los Estados Unidos: (1) describiendo las poblaciones de pacientes y las afecciones sanitarias tratadas más habitualmente; (2) definiendo las prácticas y modelos fundamentales de atención; (3) determinando cómo se reembolsaban los servicios; (4) identificando los valores y los principios subyacentes a la atención; y (5) determinando los factores principales que impulsan una implementación satisfactoria.

77 FR 8114 - Plan for Retrospective Analysis of Existing Rules

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-14

... Existing Rules without significant changes from the version that was preliminarily proposed. Accordingly... modification or elimination of existing regulations. Once an appropriate rule change has been identified, the... INTERNATIONAL TRADE COMMISSION 19 CFR Chapter II Plan for Retrospective Analysis of Existing Rules...

49 CFR 807.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 7 2010-10-01 2010-10-01 false Program accessibility: Existing facilities. 807... CONDUCTED BY THE NATIONAL TRANSPORTATION SAFETY BOARD § 807.150 Program accessibility: Existing facilities... not— (1) Necessarily require the agency to make each of its existing facilities accessible to and...

40 CFR 415.344 - Pretreatment standards for existing sources (PSES).

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 30 2013-07-01 2012-07-01 true Pretreatment standards for existing... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS INORGANIC CHEMICALS MANUFACTURING POINT SOURCE CATEGORY Chrome Pigments Production Subcategory § 415.344 Pretreatment standards for existing sources (PSES). (a) Existing...

Identification of Extraterrestrial Microbiology

NASA Technical Reports Server (NTRS)

Flynn, Michael; Rasky, Daniel J. (Technical Monitor)

1998-01-01

Many of the key questions addressed in the field of Astrobiology are based upon the assumption that life exists, or at one time existed, in locations throughout the universe. However, this assumption is just that, an assumption. No definitive proof exists. On Earth, life has been found to exist in many diverse environment. We believe that this tendency towards diversity supports the assumption that life could exists throughout the universe. This paper provides a summary of several innovative techniques for the detection of extraterrestrial life forms. The primary questions addressed are does life currently exist beyond Earth and if it does, is that life evolutionary related to life on Earth?

Existence and stability of circular orbits in static and axisymmetric spacetimes

NASA Astrophysics Data System (ADS)

Jia, Junji; Pang, Xiankai; Yang, Nan

2018-04-01

The existence and stability of timelike and null circular orbits (COs) in the equatorial plane of general static and axisymmetric (SAS) spacetime are investigated in this work. Using the fixed point approach, we first obtained a necessary and sufficient condition for the non-existence of timelike COs. It is then proven that there will always exist timelike COs at large ρ in an asymptotically flat SAS spacetime with a positive ADM mass and moreover, these timelike COs are stable. Some other sufficient conditions on the stability of timelike COs are also solved. We then found the necessary and sufficient condition on the existence of null COs. It is generally shown that the existence of timelike COs in SAS spacetime does not imply the existence of null COs, and vice-versa, regardless whether the spacetime is asymptotically flat or the ADM mass is positive or not. These results are then used to show the existence of timelike COs and their stability in an SAS Einstein-Yang-Mills-Dilaton spacetimes whose metric is not completely known. We also used the theorems to deduce the existence of timelike and null COs in some known SAS spacetimes.

12 CFR 41.20 - Scope and definitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

...-existing business relationship. (i) In general. The term “pre-existing business relationship” means a... by this subpart. (ii) Examples of pre-existing business relationships. (A) If a consumer has a time..., the depository institution has a pre-existing business relationship with the consumer and can use...

12 CFR 222.20 - Coverage and definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

...-existing business relationship—(i) In general. The term “pre-existing business relationship” means a... by this subpart. (ii) Examples of pre-existing business relationships. (A) If a consumer has a time..., the depository institution has a pre-existing business relationship with the consumer and can use...

12 CFR 717.20 - Coverage and definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

...-existing business relationship. (i) In general. The term “pre-existing business relationship” means a... by this subpart. (ii) Examples of pre-existing business relationships. (A) If a consumer has a time... federal credit union has a pre-existing business relationship with the consumer and can use eligibility...

12 CFR 222.20 - Coverage and definitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

...-existing business relationship—(i) In general. The term “pre-existing business relationship” means a... by this subpart. (ii) Examples of pre-existing business relationships. (A) If a consumer has a time..., the depository institution has a pre-existing business relationship with the consumer and can use...

12 CFR 222.20 - Coverage and definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

...-existing business relationship—(i) In general. The term “pre-existing business relationship” means a... by this subpart. (ii) Examples of pre-existing business relationships. (A) If a consumer has a time..., the depository institution has a pre-existing business relationship with the consumer and can use...

12 CFR 717.20 - Coverage and definitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

...-existing business relationship. (i) In general. The term “pre-existing business relationship” means a... by this subpart. (ii) Examples of pre-existing business relationships. (A) If a consumer has a time... federal credit union has a pre-existing business relationship with the consumer and can use eligibility...

12 CFR 41.20 - Scope and definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

...-existing business relationship—(i) In general. The term “pre-existing business relationship” means a... by this subpart. (ii) Examples of pre-existing business relationships. (A) If a consumer has a time..., the depository institution has a pre-existing business relationship with the consumer and can use...

12 CFR 41.20 - Scope and definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

...-existing business relationship.—(i) In general. The term “pre-existing business relationship” means a... by this subpart. (ii) Examples of pre-existing business relationships. (A) If a consumer has a time..., the depository institution has a pre-existing business relationship with the consumer and can use...

12 CFR 717.20 - Coverage and definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

...-existing business relationship. (i) In general. The term “pre-existing business relationship” means a... by this subpart. (ii) Examples of pre-existing business relationships. (A) If a consumer has a time... federal credit union has a pre-existing business relationship with the consumer and can use eligibility...

43 CFR 17.550 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 43 Public Lands: Interior 1 2011-10-01 2011-10-01 false Program accessibility: Existing facilities....550 Program accessibility: Existing facilities. (a) General. The agency shall operate each program or... its existing facilities or every part of a facility accessible to and usable by handicapped persons...

49 CFR 28.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 1 2011-10-01 2011-10-01 false Program accessibility: Existing facilities. 28.150....150 Program accessibility: Existing facilities. (a) General. The Department shall operate each program... Department to make each of its existing facilities accessible to and usable by individuals with handicaps; (2...

77 FR 65645 - Retrospective Analysis of Existing Rules: Notice of Staff Memorandum

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-30

...] Retrospective Analysis of Existing Rules: Notice of Staff Memorandum SUMMARY: Take notice that the Commission... Analysis of Existing Rules prepared in response to Executive Order 13579, which requested independent regulatory agencies issue plans for periodic retrospective analysis of their existing regulations. [[Page...

10 CFR 611.206 - Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Existing facilities. 611.206 Section 611.206 Energy... PROGRAM Facility/Funding Awards § 611.206 Existing facilities. The Secretary shall, in making awards to those manufacturers that have existing facilities, give priority to those facilities that are oldest or...

42 CFR 457.440 - Existing comprehensive State-based coverage.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Existing comprehensive State-based coverage. 457... STATES State Plan Requirements: Coverage and Benefits § 457.440 Existing comprehensive State-based coverage. (a) General requirements. Existing comprehensive State-based health benefits is coverage that— (1...

48 CFR 227.7105-3 - Acquisition of modified existing works.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Rights in Technical Data 227.7105-3 Acquisition of modified existing works. Use the clause at 252.227-7020, Rights in Special Works, in solicitations and contracts for modified existing works in lieu of the clause at 252.227-7021, Rights in Data—Existing Works. ...

14 CFR 1203.604 - Mandatory review for declassification.

Code of Federal Regulations, 2012 CFR

2012-01-01

... request is made by a United States citizen or permanent resident alien, a Federal agency, or a State or... deny the existence or non-existence of requested information whenever the fact of its existence or non-existence is itself classifiable under “the Order.” (g) Declassification of transferred documents or...

14 CFR 1203.604 - Mandatory review for declassification.

Code of Federal Regulations, 2013 CFR

2013-01-01

... request is made by a United States citizen or permanent resident alien, a Federal agency, or a State or... deny the existence or non-existence of requested information whenever the fact of its existence or non-existence is itself classifiable under “the Order.” (g) Declassification of transferred documents or...

75 FR 45013 - Pre-Existing Condition Insurance Plan Program

Federal Register 2010, 2011, 2012, 2013, 2014

2010-07-30

... provided (an important protection for a program designed to offer coverage to those with a pre-existing... Part II Department of Health and Human Services 45 CFR Part 152 Pre-Existing Condition Insurance... [OCIIO-9995-IFC] RIN 0991-AB71 Pre-Existing Condition Insurance Plan Program AGENCY: Office of Consumer...

76 FR 76180 - Notice of Realty Action: Termination of Segregation, Opening of Public Lands; Montana

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-06

...] Notice of Realty Action: Termination of Segregation, Opening of Public Lands; Montana AGENCY: Bureau of... generally, subject to valid existing rights, the provisions of existing withdrawals, other segregations of..., subject to valid existing rights, the provision of existing withdrawals, other segregations of record, and...

40 CFR 258.16 - Closure of existing municipal solid waste landfill units.

Code of Federal Regulations, 2011 CFR

2011-07-01

... (CONTINUED) SOLID WASTES CRITERIA FOR MUNICIPAL SOLID WASTE LANDFILLS Location Restrictions § 258.16 Closure of existing municipal solid waste landfill units. (a) Existing MSWLF units that cannot make the... 40 Protection of Environment 25 2011-07-01 2011-07-01 false Closure of existing municipal solid...

40 CFR 258.16 - Closure of existing municipal solid waste landfill units.

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) SOLID WASTES CRITERIA FOR MUNICIPAL SOLID WASTE LANDFILLS Location Restrictions § 258.16 Closure of existing municipal solid waste landfill units. (a) Existing MSWLF units that cannot make the... 40 Protection of Environment 24 2010-07-01 2010-07-01 false Closure of existing municipal solid...

10 CFR 611.206 - Existing facilities.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 4 2013-01-01 2013-01-01 false Existing facilities. 611.206 Section 611.206 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS ADVANCED TECHNOLOGY VEHICLES MANUFACTURER ASSISTANCE PROGRAM Facility/Funding Awards § 611.206 Existing facilities. The Secretary shall, in making awards to those manufacturers that have existing...

10 CFR 611.206 - Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 4 2011-01-01 2011-01-01 false Existing facilities. 611.206 Section 611.206 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS ADVANCED TECHNOLOGY VEHICLES MANUFACTURER ASSISTANCE PROGRAM Facility/Funding Awards § 611.206 Existing facilities. The Secretary shall, in making awards to those manufacturers that have existing...

10 CFR 611.206 - Existing facilities.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 4 2014-01-01 2014-01-01 false Existing facilities. 611.206 Section 611.206 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS ADVANCED TECHNOLOGY VEHICLES MANUFACTURER ASSISTANCE PROGRAM Facility/Funding Awards § 611.206 Existing facilities. The Secretary shall, in making awards to those manufacturers that have existing...

10 CFR 611.206 - Existing facilities.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 4 2012-01-01 2012-01-01 false Existing facilities. 611.206 Section 611.206 Energy DEPARTMENT OF ENERGY (CONTINUED) ASSISTANCE REGULATIONS ADVANCED TECHNOLOGY VEHICLES MANUFACTURER ASSISTANCE PROGRAM Facility/Funding Awards § 611.206 Existing facilities. The Secretary shall, in making awards to those manufacturers that have existing...

47 CFR 22.601 - Existing microwave stations licensed under this part.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 2 2014-10-01 2014-10-01 false Existing microwave stations licensed under this....601 Existing microwave stations licensed under this part. Existing microwave stations (2110-2130 and... in § 22.602. No new microwave systems will be authorized under this part. (a) Coordination required...

47 CFR 22.601 - Existing microwave stations licensed under this part.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 2 2011-10-01 2011-10-01 false Existing microwave stations licensed under this....601 Existing microwave stations licensed under this part. Existing microwave stations (2110-2130 and... in § 22.602. No new microwave systems will be authorized under this part. (a) Coordination required...

47 CFR 22.601 - Existing microwave stations licensed under this part.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 2 2010-10-01 2010-10-01 false Existing microwave stations licensed under this....601 Existing microwave stations licensed under this part. Existing microwave stations (2110-2130 and... in § 22.602. No new microwave systems will be authorized under this part. (a) Coordination required...

47 CFR 22.601 - Existing microwave stations licensed under this part.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 2 2012-10-01 2012-10-01 false Existing microwave stations licensed under this....601 Existing microwave stations licensed under this part. Existing microwave stations (2110-2130 and... in § 22.602. No new microwave systems will be authorized under this part. (a) Coordination required...

47 CFR 22.601 - Existing microwave stations licensed under this part.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 2 2013-10-01 2013-10-01 false Existing microwave stations licensed under this....601 Existing microwave stations licensed under this part. Existing microwave stations (2110-2130 and... in § 22.602. No new microwave systems will be authorized under this part. (a) Coordination required...

46 CFR 154.12 - Existing gas vessel: Endorsements and requirements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... DANGEROUS CARGOES SAFETY STANDARDS FOR SELF-PROPELLED VESSELS CARRYING BULK LIQUEFIED GASES General § 154.12 Existing gas vessel: Endorsements and requirements. (a) Except an existing gas vessel under paragraph (b... 46 Shipping 5 2012-10-01 2012-10-01 false Existing gas vessel: Endorsements and requirements. 154...

46 CFR 154.12 - Existing gas vessel: Endorsements and requirements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... DANGEROUS CARGOES SAFETY STANDARDS FOR SELF-PROPELLED VESSELS CARRYING BULK LIQUEFIED GASES General § 154.12 Existing gas vessel: Endorsements and requirements. (a) Except an existing gas vessel under paragraph (b... 46 Shipping 5 2014-10-01 2014-10-01 false Existing gas vessel: Endorsements and requirements. 154...

Morphology and ultrastructure of the freshwater rotifer Brachionus bidentatus (Monogononta: Brachionidae) using scanning and transmission electron microscopy.

PubMed

Guerrero-Jiménez, Gerardo; Zavala-Padilla, Guadalupe; Silva-Briano, Marcelo; Rico-Martínez, Roberto

2013-12-01

The study of sexual reproductive behavior supported by ultrastructural evidence is important in rotifers to describe differences among potential cryptic species. In this research, the morphology of the rotifer Brachionus bidentatus is described at the ultrastructural level, using electronic microscopy, together with a brief description and discussion of its sexual reproductive behavior. The characteristics of the (a) male, (b) the female, (c) the sexual egg or cyst, (d) the partenogenic egg, (e) the no-fecundated sexual egg (male egg), and (f) the trophi, were described. Another part of this research is dedicated to the ultrastructure of the sex cells of the male rotifer B. bidentatus. Samples were obtained from La Punta pond in Cosio, Aguascalientes, Mexico (22 degrees 08' N - 102 degrees 24' W), and a culture was maintained in the laboratory. Fifty organisms, from different stages of the rotifer Brachionus bidentatus, were fixed in Formol at 4% and then prepared; besides, for the trophi, 25 female rotifer Brachionus bidentatus were prepared for observation in a JEOL 5900 LV scanning electronic microscope. In addition, for the observation of male sex cells, 500 males of Brachionus bidentatus were isolated, fixed and observed in a JEOL 1010 transmission microscope. Females of B. bidentatus in laboratory cultures had a lifespan of five days (mean+one SD = 4.69 +/- 0.48; N=13), and produced 4.5 +/- 3.67 (N=6) parthenogenetic eggs during such lifespan. In the case of non-fertilized sexual eggs, they produced up to 18 eggs (mean+one SD = 13 +/- 4.93; N=7). Sexual females produced a single cyst on average (mean +/- one SD = I +/- 0; N=20). For the sexual cycle, the time of copulation between male and female ranged from 10 to 40 seconds (mean +/- one SD = 17.33 +/- 10.55, N=7). The spermatozoa are composed of a celular body and a flagellum, the size of the body is of 300 nm while the flagellum measures 1 700nm. The rods have a double membrane. Their mean length is almost 2.45 microm +/- 0.74, N=6; and their mean wide is 0.773 microm +/- 0.241, N=11. The evidence on the specific ultrastructural characteristics of the rotifer B. bidentatus is notorious, even more in the male and in the cyst cell. Regarding the ultrastructure of the spermatozoa and the rods, compared to other species they only differ in size, despite their structural resemblance. Our study of the ultraestructure of this species adds useful information that along with molecular data will help clarify the taxonomy of brachionid rotifers.

12 CFR 403.7 - Mandatory review for declassification.

Code of Federal Regulations, 2011 CFR

2011-01-01

... of a request by a United States citizen or permanent resident alien, a Federal agency, or a State or... material on grounds other than classification. (i) The Bank shall refuse to confirm or deny the existence or non-existence of requested information whenever the fact of its existence or non-existence is...

12 CFR 403.7 - Mandatory review for declassification.

Code of Federal Regulations, 2012 CFR

2012-01-01

... of a request by a United States citizen or permanent resident alien, a Federal agency, or a State or... material on grounds other than classification. (i) The Bank shall refuse to confirm or deny the existence or non-existence of requested information whenever the fact of its existence or non-existence is...

12 CFR 403.7 - Mandatory review for declassification.

Code of Federal Regulations, 2014 CFR

2014-01-01

... of a request by a United States citizen or permanent resident alien, a Federal agency, or a State or... material on grounds other than classification. (i) The Bank shall refuse to confirm or deny the existence or non-existence of requested information whenever the fact of its existence or non-existence is...

12 CFR 403.7 - Mandatory review for declassification.

Code of Federal Regulations, 2013 CFR

2013-01-01

... of a request by a United States citizen or permanent resident alien, a Federal agency, or a State or... material on grounds other than classification. (i) The Bank shall refuse to confirm or deny the existence or non-existence of requested information whenever the fact of its existence or non-existence is...

40 CFR 60.2992 - What is an existing incineration unit?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 6 2010-07-01 2010-07-01 false What is an existing incineration unit... Times for Other Solid Waste Incineration Units That Commenced Construction On or Before December 9, 2004 Applicability of State Plans § 60.2992 What is an existing incineration unit? An existing incineration unit is...

12 CFR 563b.435 - What happens to my corporate existence after conversion?

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 5 2010-01-01 2010-01-01 false What happens to my corporate existence after... What happens to my corporate existence after conversion? Your corporate existence will continue following your conversion, unless you convert to a state-chartered stock savings association and state law...

48 CFR 27.405-2 - Existing works.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 1 2011-10-01 2011-10-01 false Existing works. 27.405-2... REQUIREMENTS PATENTS, DATA, AND COPYRIGHTS Rights in Data and Copyrights 27.405-2 Existing works. The clause at 52.227-18, Rights in Data—Existing Works, is for use in contracts exclusively for the acquisition...

48 CFR 27.405-2 - Existing works.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Existing works. 27.405-2... REQUIREMENTS PATENTS, DATA, AND COPYRIGHTS Rights in Data and Copyrights 27.405-2 Existing works. The clause at 52.227-18, Rights in Data—Existing Works, is for use in contracts exclusively for the acquisition...

46 CFR 173.055 - Watertight subdivision and damage stability standards for existing sailing school vessels.

Code of Federal Regulations, 2011 CFR

2011-10-01

... for existing sailing school vessels. 173.055 Section 173.055 Shipping COAST GUARD, DEPARTMENT OF... § 173.055 Watertight subdivision and damage stability standards for existing sailing school vessels. (a) Except as provided in paragraph (c) of this section, an existing sailing school vessel which carries more...

46 CFR 173.055 - Watertight subdivision and damage stability standards for existing sailing school vessels.

Code of Federal Regulations, 2010 CFR

2010-10-01

... for existing sailing school vessels. 173.055 Section 173.055 Shipping COAST GUARD, DEPARTMENT OF... § 173.055 Watertight subdivision and damage stability standards for existing sailing school vessels. (a) Except as provided in paragraph (c) of this section, an existing sailing school vessel which carries more...

77 FR 22378 - Noise Exposure Map Notice; Lafayette Regional Airport, Lafayette, LA

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-13

..., Existing and Future Condition Flight Tracks, Arrival and Departure--Runway 04L/R; Exhibit 4.3, Existing and Future Condition Flight Tracks, Arrival and Departure--Runway 11; Exhibit 4.4, Existing and Future Condition Flight Tracks, Arrival and Departure--Runway 22L/R; Exhibit 4.5, Existing and Future Condition...

29 CFR 779.223 - Control where ownership vested in individual or single organization.

Code of Federal Regulations, 2010 CFR

2010-07-01

... single business organization. Ownership sufficient to exercise “control” exist also where there is more... in individual or single organization. Ownership, sufficient to exercise “control,” of course, exists... “control” may exist with much more limited ownership, and, in certain cases exists in the absence of any...

5 CFR 175.102 - Requests for the declassification of documents.

Code of Federal Regulations, 2011 CFR

2011-01-01

... classified for national security purposes by the Civil Service Commission. The Office of Personnel Management... applicable law. (c) No OPM official will refuse to confirm the existence or non-existence of any document..., unless the fact of its existence or non-existence would itself be classifiable under the Executive order...

48 CFR 227.7105-2 - Acquisition of existing works without modification.

Code of Federal Regulations, 2010 CFR

2010-10-01

... COPYRIGHTS Rights in Technical Data 227.7105-2 Acquisition of existing works without modification. (a) Use the clause at 252.227-7021, Rights in Data—Existing Works, in lieu of the clause at 252.227-7013... requires the right to reproduce, prepare derivative works, or publicly perform or display the existing...

Hydraulic and Condition Assessment of Existing Sewerage Network: A Case Study of an Educational Institute

NASA Astrophysics Data System (ADS)

Sourabh, Nishant; Timbadiya, P. V.

2018-04-01

The hydraulic simulation of the existing sewerage network provides various information about critical points to assess the deteriorating condition and help in rehabilitation of existing network and future expansion. In the present study, hydraulic and condition assessment of existing network of educational Institute (i.e. Sardar Vallabhbhai National Institute of Technology-Surat, Gujarat, India), having an area of 100 ha and ground levels in range of 5.0-9.0 m above mean sea level, has been carried out using sewage flow simulation for existing and future scenarios analysis using SewerGEMS v8i. The paper describes the features of 4.79 km long sewerage network of institute followed by network model simulation for aforesaid scenarios and recommendations on improvement of the existing network for future use. The total sewer loads for present and future scenarios are 1.67 million litres per day (MLD) and 3.62 MLD, considering the peak factor of 3 on the basis of population. The hydraulic simulation of the existing scenario indicated depth by diameter (d/D) ratio in the range of 0.02-0.48 and velocity range of 0.08-0.53 m/s for existing network for present scenario. For the future scenario, the existing network is needed to be modified and it was found that total of 11 conduits (length: 464.8 m) should be replaced to the next higher diameter available, i.e., 350 mm for utilization of existing network for future scenario. The present study provides the methodology for condition assessment of existing network and its utilization as per guidelines provided by Central Public Health and Environmental Engineering Organization, 2013. The methodology presented in this paper can be used by municipal/public health engineer for the assessment of existing sewerage network for its serviceability and improvement in future.

46 CFR 4.05-25 - Reports when state of war exists.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 1 2010-10-01 2010-10-01 false Reports when state of war exists. 4.05-25 Section 4.05-25 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY PROCEDURES APPLICABLE TO THE PUBLIC MARINE... war exists. During the period when a state of war exists between the United States and any foreign...

36 CFR 9.43 - Precautions necessary in areas where high pressures are likely to exist.

Code of Federal Regulations, 2010 CFR

2010-07-01

... areas where high pressures are likely to exist. 9.43 Section 9.43 Parks, Forests, and Public Property... Precautions necessary in areas where high pressures are likely to exist. When drilling in “wildcat” territory, or in any field where high pressures are likely to exist, the operator shall take all necessary...

Leveraging existing technology to boost revenue cycle performance.

PubMed

Wagner, Karen

2012-09-01

Revenue cycle leaders can reduce the frequency or level of technology investment needed while maintaining strong service and payment accuracy by looking at four areas of opportunity: Applying output from existing technology in new ways Seeking new functionality from existing systems. Linking with external systems to provide greater capabilities. Supplementing limitations of existing technology with outside expertise.

15 CFR 922.47 - Pre-existing authorizations or rights and certifications of pre-existing authorizations or rights.

Code of Federal Regulations, 2011 CFR

2011-01-01

... rights of subsistence use or access in existence on the date of designation of any National Marine... leases, permits, licenses, or rights consistent with the purposes for which the Sanctuary was designated... authorized by a valid lease, permit, license, approval or other authorization in existence on the effective...

26 CFR 1.414(c)-6 - Effective date.

Code of Federal Regulations, 2011 CFR

2011-04-01

..., 1974. (b) Existing plans. In the case of a plan in existence on January 1, 1974, unless paragraph (c... § 1.410(a)-2(c). (c) Existing plans electing new provisions. In the case of a plan in existence on....410 (a)-2 (d). (d) Application. For purposes of the Employee Retirement Income Security Act of 1974...

15 CFR 922.47 - Pre-existing authorizations or rights and certifications of pre-existing authorizations or rights.

Code of Federal Regulations, 2010 CFR

2010-01-01

... rights of subsistence use or access in existence on the date of designation of any National Marine... leases, permits, licenses, or rights consistent with the purposes for which the Sanctuary was designated... authorized by a valid lease, permit, license, approval or other authorization in existence on the effective...

26 CFR 1.414(c)-6 - Effective date.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., 1974. (b) Existing plans. In the case of a plan in existence on January 1, 1974, unless paragraph (c... § 1.410(a)-2(c). (c) Existing plans electing new provisions. In the case of a plan in existence on....410 (a)-2 (d). (d) Application. For purposes of the Employee Retirement Income Security Act of 1974...

48 CFR 252.227-7021 - Rights in data-existing works.

Code of Federal Regulations, 2010 CFR

2010-10-01

... of Provisions And Clauses 252.227-7021 Rights in data—existing works. As prescribed at 227.7105-2(a), use the following clause: Rights in Data—Existing Works (MAR 1979) (a) The term works as used herein... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Rights in data-existing...

Flattening Property and the Existence of Global Attractors in Banach Space

NASA Astrophysics Data System (ADS)

Aris, Naimah; Maharani, Sitti; Jusmawati, Massalesse; Nurwahyu, Budi

2018-03-01

This paper analyses the existence of global attractor in infinite dimensional system using flattening property. The earlier stage we show the existence of the global attractor in complete metric space by using concept of the ω-limit compact concept with measure of non-compactness methods. Then we show that the ω-limit compact concept is equivalent with the flattening property in Banach space. If we can prove there exist an absorbing set in the system and the flattening property holds, then the global attractor exist in the system.

A hybrid voice/data modulation for the VHF aeronautical channels

NASA Technical Reports Server (NTRS)

Akos, Dennis M.

1993-01-01

A method of improving the spectral efficiency of the existing Very High Frequency (VHF) Amplitude Modulation (AM) voice communication channels is proposed. The technique is to phase modulate the existing voice amplitude modulated carrier with digital data. This allows the transmission of digital information over an existing AM voice channel with no change to the existing AM signal format. There is no modification to the existing AM receiver to demodulate the voice signal and an additional receiver module can be added for processing of the digital data. The existing VHF AM transmitter requires only a slight modification for the addition of the digital data signal. The past work in the area is summarized and presented together with an improved system design and the proposed implementation.

Greening Existing Tribal Buildings

EPA Pesticide Factsheets

Guidance about improving sustainability in existing tribal casinos and manufactured homes. Many steps can be taken to make existing buildings greener and healthier. They may also reduce utility and medical costs.

30 CFR 761.12 - Exception for existing operations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... program, exists when the land comes under the protection of § 761.11. This exception applies only to lands within the permit area as it exists when the land comes under the protection of § 761.11. (b) With... coal mining operations exist when the land comes under the protection of 30 U.S.C. 1272(e) or § 761.11...

30 CFR 761.12 - Exception for existing operations.

Code of Federal Regulations, 2014 CFR

2014-07-01

... program, exists when the land comes under the protection of § 761.11. This exception applies only to lands within the permit area as it exists when the land comes under the protection of § 761.11. (b) With... coal mining operations exist when the land comes under the protection of 30 U.S.C. 1272(e) or § 761.11...

30 CFR 761.12 - Exception for existing operations.

Code of Federal Regulations, 2011 CFR

2011-07-01

... program, exists when the land comes under the protection of § 761.11. This exception applies only to lands within the permit area as it exists when the land comes under the protection of § 761.11. (b) With... coal mining operations exist when the land comes under the protection of 30 U.S.C. 1272(e) or § 761.11...

30 CFR 761.12 - Exception for existing operations.

Code of Federal Regulations, 2013 CFR

2013-07-01

... program, exists when the land comes under the protection of § 761.11. This exception applies only to lands within the permit area as it exists when the land comes under the protection of § 761.11. (b) With... coal mining operations exist when the land comes under the protection of 30 U.S.C. 1272(e) or § 761.11...

30 CFR 761.12 - Exception for existing operations.

Code of Federal Regulations, 2012 CFR

2012-07-01

... program, exists when the land comes under the protection of § 761.11. This exception applies only to lands within the permit area as it exists when the land comes under the protection of § 761.11. (b) With... coal mining operations exist when the land comes under the protection of 30 U.S.C. 1272(e) or § 761.11...

26 CFR 1.1311(b)-3 - Existence of relationship in case of adjustment by way of deficiency assessment.

Code of Federal Regulations, 2010 CFR

2010-04-01

... maintained. If the inconsistent position was not thus maintained, then the relationship must exist on the... 26 Internal Revenue 11 2010-04-01 2010-04-01 true Existence of relationship in case of adjustment... Between Years and Special Limitations § 1.1311(b)-3 Existence of relationship in case of adjustment by way...

40 CFR 429.145 - Pretreatment standards for existing sources (PSES).

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS TIMBER PRODUCTS PROCESSING POINT SOURCE CATEGORY Particleboard Manufacturing Subcategory § 429.145 Pretreatment standards for existing sources (PSES). Any existing source...

40 CFR 415.124 - Pretreatment standards for existing sources (PSES).

Code of Federal Regulations, 2013 CFR

2013-07-01

... Potassium Dichromate Production Subcategory § 415.124 Pretreatment standards for existing sources (PSES... following pretreatment standards for existing sources (PSES): Subpart L—Potassium Dichromate Pollutant or...

40 CFR 415.124 - Pretreatment standards for existing sources (PSES).

Code of Federal Regulations, 2010 CFR

2010-07-01

... Potassium Dichromate Production Subcategory § 415.124 Pretreatment standards for existing sources (PSES... following pretreatment standards for existing sources (PSES): Subpart L—Potassium Dichromate Pollutant or...

40 CFR 417.84 - Pretreatment standards for existing sources.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) EFFLUENT GUIDELINES AND STANDARDS SOAP AND DETERGENT MANUFACTURING POINT SOURCE CATEGORY Manufacture of Liquid Soaps Subcategory § 417.84 Pretreatment standards for existing sources. Any existing source...

40 CFR 417.84 - Pretreatment standards for existing sources.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) EFFLUENT GUIDELINES AND STANDARDS SOAP AND DETERGENT MANUFACTURING POINT SOURCE CATEGORY Manufacture of Liquid Soaps Subcategory § 417.84 Pretreatment standards for existing sources. Any existing source...

40 CFR 417.84 - Pretreatment standards for existing sources.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) EFFLUENT GUIDELINES AND STANDARDS SOAP AND DETERGENT MANUFACTURING POINT SOURCE CATEGORY Manufacture of Liquid Soaps Subcategory § 417.84 Pretreatment standards for existing sources. Any existing source...

40 CFR 417.84 - Pretreatment standards for existing sources.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) EFFLUENT GUIDELINES AND STANDARDS SOAP AND DETERGENT MANUFACTURING POINT SOURCE CATEGORY Manufacture of Liquid Soaps Subcategory § 417.84 Pretreatment standards for existing sources. Any existing source...

40 CFR 417.84 - Pretreatment standards for existing sources.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) EFFLUENT GUIDELINES AND STANDARDS SOAP AND DETERGENT MANUFACTURING POINT SOURCE CATEGORY Manufacture of Liquid Soaps Subcategory § 417.84 Pretreatment standards for existing sources. Any existing source...

40 CFR 415.124 - Pretreatment standards for existing sources (PSES).

Code of Federal Regulations, 2011 CFR

2011-07-01

... Potassium Dichromate Production Subcategory § 415.124 Pretreatment standards for existing sources (PSES... following pretreatment standards for existing sources (PSES): Subpart L—Potassium Dichromate Pollutant or...

40 CFR 415.124 - Pretreatment standards for existing sources (PSES).

Code of Federal Regulations, 2012 CFR

2012-07-01

... Potassium Dichromate Production Subcategory § 415.124 Pretreatment standards for existing sources (PSES... following pretreatment standards for existing sources (PSES): Subpart L—Potassium Dichromate Pollutant or...

40 CFR 415.124 - Pretreatment standards for existing sources (PSES).

Code of Federal Regulations, 2014 CFR

2014-07-01

... Potassium Dichromate Production Subcategory § 415.124 Pretreatment standards for existing sources (PSES... following pretreatment standards for existing sources (PSES): Subpart L—Potassium Dichromate Pollutant or...

Evans functions and bifurcations of nonlinear waves of some nonlinear reaction diffusion equations

NASA Astrophysics Data System (ADS)

Zhang, Linghai

2017-10-01

The main purposes of this paper are to accomplish the existence, stability, instability and bifurcation of the nonlinear waves of the nonlinear system of reaction diffusion equations ut =uxx + α [ βH (u - θ) - u ] - w, wt = ε (u - γw) and to establish the existence, stability, instability and bifurcation of the nonlinear waves of the nonlinear scalar reaction diffusion equation ut =uxx + α [ βH (u - θ) - u ], under different conditions on the model constants. To establish the bifurcation for the system, we will study the existence and instability of a standing pulse solution if 0 < 2 (1 + αγ) θ < αβγ; the existence and stability of two standing wave fronts if 2 (1 + αγ) θ = αβγ and γ2 ε > 1; the existence and instability of two standing wave fronts if 2 (1 + αγ) θ = αβγ and 0 <γ2 ε < 1; the existence and instability of an upside down standing pulse solution if 0 < (1 + αγ) θ < αβγ < 2 (1 + αγ) θ. To establish the bifurcation for the scalar equation, we will study the existence and stability of a traveling wave front as well as the existence and instability of a standing pulse solution if 0 < 2 θ < β; the existence and stability of two standing wave fronts if 2 θ = β; the existence and stability of a traveling wave front as well as the existence and instability of an upside down standing pulse solution if 0 < θ < β < 2 θ. By the way, we will also study the existence and stability of a traveling wave back of the nonlinear scalar reaction diffusion equation ut =uxx + α [ βH (u - θ) - u ] -w0, where w0 = α (β - 2 θ) > 0 is a positive constant, if 0 < 2 θ < β. To achieve the main goals, we will make complete use of the special structures of the model equations and we will construct Evans functions and apply them to study the eigenvalues and eigenfunctions of several eigenvalue problems associated with several linear differential operators. It turns out that a complex number λ0 is an eigenvalue of the linear differential operator, if and only if λ0 is a zero of the Evans function. The stability, instability and bifurcations of the nonlinear waves follow from the zeros of the Evans functions. A very important motivation to study the existence, stability, instability and bifurcations of the nonlinear waves is to study the existence and stability/instability of infinitely many fast/slow multiple traveling pulse solutions of the nonlinear system of reaction diffusion equations. The existence and stability of infinitely many fast multiple traveling pulse solutions are of great interests in mathematical neuroscience.

40 CFR 417.64 - Pretreatment standards for existing sources.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) EFFLUENT GUIDELINES AND STANDARDS SOAP AND DETERGENT MANUFACTURING POINT SOURCE CATEGORY Manufacture of Soap Flakes and Powders Subcategory § 417.64 Pretreatment standards for existing sources. Any existing...

40 CFR 417.64 - Pretreatment standards for existing sources.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) EFFLUENT GUIDELINES AND STANDARDS SOAP AND DETERGENT MANUFACTURING POINT SOURCE CATEGORY Manufacture of Soap Flakes and Powders Subcategory § 417.64 Pretreatment standards for existing sources. Any existing...

40 CFR 417.64 - Pretreatment standards for existing sources.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) EFFLUENT GUIDELINES AND STANDARDS SOAP AND DETERGENT MANUFACTURING POINT SOURCE CATEGORY Manufacture of Soap Flakes and Powders Subcategory § 417.64 Pretreatment standards for existing sources. Any existing...

40 CFR 417.64 - Pretreatment standards for existing sources.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) EFFLUENT GUIDELINES AND STANDARDS SOAP AND DETERGENT MANUFACTURING POINT SOURCE CATEGORY Manufacture of Soap Flakes and Powders Subcategory § 417.64 Pretreatment standards for existing sources. Any existing...

40 CFR 417.64 - Pretreatment standards for existing sources.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) EFFLUENT GUIDELINES AND STANDARDS SOAP AND DETERGENT MANUFACTURING POINT SOURCE CATEGORY Manufacture of Soap Flakes and Powders Subcategory § 417.64 Pretreatment standards for existing sources. Any existing...

40 CFR 415.534 - Pretreatment standards for existing sources (PSES).

Code of Federal Regulations, 2010 CFR

2010-07-01

... Nitrate Production Subcategory § 415.534 Pretreatment standards for existing sources (PSES). Except as... pretreatment standards for existing sources (PSES): Subpart BA—Silver Nitrate Pollution or pollutant property...

40 CFR 415.534 - Pretreatment standards for existing sources (PSES).

Code of Federal Regulations, 2011 CFR

2011-07-01

... Nitrate Production Subcategory § 415.534 Pretreatment standards for existing sources (PSES). Except as... pretreatment standards for existing sources (PSES): Subpart BA—Silver Nitrate Pollution or pollutant property...

24 CFR 200.24 - Existing projects.

Code of Federal Regulations, 2010 CFR

2010-04-01

... section 207 of the Act, or for refinancing the existing debt of an existing nursing home, intermediate care facility, assisted living facility, or board and care home, or any combination thereof, under...

40 CFR 415.384 - Pretreatment standards for existing sources (PSES).

Code of Federal Regulations, 2010 CFR

2010-07-01

... Chloride Production Subcategory § 415.384 Pretreatment standards for existing sources (PSES). Except as... pretreatment standards for existing sources (PSES): Subpart AL—Ferric Chloride Pollutant or pollutant property...

40 CFR 417.74 - Pretreatment standards for existing sources.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) EFFLUENT GUIDELINES AND STANDARDS SOAP AND DETERGENT MANUFACTURING POINT SOURCE CATEGORY Manufacture of Bar Soaps Subcategory § 417.74 Pretreatment standards for existing sources. Any existing source subject to...

40 CFR 417.74 - Pretreatment standards for existing sources.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) EFFLUENT GUIDELINES AND STANDARDS SOAP AND DETERGENT MANUFACTURING POINT SOURCE CATEGORY Manufacture of Bar Soaps Subcategory § 417.74 Pretreatment standards for existing sources. Any existing source subject to...

40 CFR 417.74 - Pretreatment standards for existing sources.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) EFFLUENT GUIDELINES AND STANDARDS SOAP AND DETERGENT MANUFACTURING POINT SOURCE CATEGORY Manufacture of Bar Soaps Subcategory § 417.74 Pretreatment standards for existing sources. Any existing source subject to...

40 CFR 417.74 - Pretreatment standards for existing sources.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) EFFLUENT GUIDELINES AND STANDARDS SOAP AND DETERGENT MANUFACTURING POINT SOURCE CATEGORY Manufacture of Bar Soaps Subcategory § 417.74 Pretreatment standards for existing sources. Any existing source subject to...

40 CFR 417.74 - Pretreatment standards for existing sources.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) EFFLUENT GUIDELINES AND STANDARDS SOAP AND DETERGENT MANUFACTURING POINT SOURCE CATEGORY Manufacture of Bar Soaps Subcategory § 417.74 Pretreatment standards for existing sources. Any existing source subject to...

40 CFR 415.534 - Pretreatment standards for existing sources (PSES).

Code of Federal Regulations, 2014 CFR

2014-07-01

... Nitrate Production Subcategory § 415.534 Pretreatment standards for existing sources (PSES). Except as... pretreatment standards for existing sources (PSES): Subpart BA—Silver Nitrate Pollution or pollutant property...

40 CFR 415.534 - Pretreatment standards for existing sources (PSES).

Code of Federal Regulations, 2013 CFR

2013-07-01

... Nitrate Production Subcategory § 415.534 Pretreatment standards for existing sources (PSES). Except as... pretreatment standards for existing sources (PSES): Subpart BA—Silver Nitrate Pollution or pollutant property...

40 CFR 415.534 - Pretreatment standards for existing sources (PSES).

Code of Federal Regulations, 2012 CFR

2012-07-01

... Nitrate Production Subcategory § 415.534 Pretreatment standards for existing sources (PSES). Except as... pretreatment standards for existing sources (PSES): Subpart BA—Silver Nitrate Pollution or pollutant property...

24 CFR 235.1234 - Term of assistance payment contract in connection with mortgages insured under section 235(r) of...

Code of Federal Regulations, 2010 CFR

2010-04-01

.... (a) Existing contracts with original terms in excess of ten years. In cases where the existing contract has an original term in excess of ten years, the term of the new assistance payments contract in.... (b) Existing ten year contracts. (1) In cases of existing ten year contracts, the term of the new...

40 CFR 63.6604 - What fuel requirements must I meet if I own or operate an existing stationary CI RICE?

Code of Federal Regulations, 2011 CFR

2011-07-01

... I own or operate an existing stationary CI RICE? 63.6604 Section 63.6604 Protection of Environment....6604 What fuel requirements must I meet if I own or operate an existing stationary CI RICE? If you own or operate an existing non-emergency, non-black start CI stationary RICE with a site rating of more...

Final Environmental Assessment for Aircraft Maintenance Operations Center

DTIC Science & Technology

2014-06-01

short-term emissions during construction of new facilities, demolition of existing buildings, and removal of existing asphalt /concrete. There would...Repair: The existing asphalt road accessing Building 1934 would be repaired in June 2014. It is anticipated that this project would qualify for a CatEx...removal of existing asphalt /concrete. Minimal ambient air impacts from localized short-term emissions that would quickly dissipate away from the

Cue-based assertion classification for Swedish clinical text – developing a lexicon for pyConTextSwe

PubMed Central

Velupillai, Sumithra; Skeppstedt, Maria; Kvist, Maria; Mowery, Danielle; Chapman, Brian E.; Dalianis, Hercules; Chapman, Wendy W.

2014-01-01

Objective The ability of a cue-based system to accurately assert whether a disorder is affirmed, negated, or uncertain is dependent, in part, on its cue lexicon. In this paper, we continue our study of porting an assertion system (pyConTextNLP) from English to Swedish (pyConTextSwe) by creating an optimized assertion lexicon for clinical Swedish. Methods and material We integrated cues from four external lexicons, along with generated inflections and combinations. We used subsets of a clinical corpus in Swedish. We applied four assertion classes (definite existence, probable existence, probable negated existence and definite negated existence) and two binary classes (existence yes/no and uncertainty yes/no) to pyConTextSwe. We compared pyConTextSwe’s performance with and without the added cues on a development set, and improved the lexicon further after an error analysis. On a separate evaluation set, we calculated the system’s final performance. Results Following integration steps, we added 454 cues to pyConTextSwe. The optimized lexicon developed after an error analysis resulted in statistically significant improvements on the development set (83% F-score, overall). The system’s final F-scores on an evaluation set were 81% (overall). For the individual assertion classes, F-score results were 88% (definite existence), 81% (probable existence), 55% (probable negated existence), and 63% (definite negated existence). For the binary classifications existence yes/no and uncertainty yes/no, final system performance was 97%/87% and 78%/86% F-score, respectively. Conclusions We have successfully ported pyConTextNLP to Swedish (pyConTextSwe). We have created an extensive and useful assertion lexicon for Swedish clinical text, which could form a valuable resource for similar studies, and which is publicly available. PMID:24556644

Comparison of maternal morbidity and medical costs during pregnancy and delivery between patients with gestational diabetes and patients with pre-existing diabetes

PubMed Central

Son, K H; Lim, N-K; Lee, J-W; Cho, M-C; Park, H-Y

2015-01-01

Aims To evaluate the effects of gestational diabetes and pre-existing diabetes on maternal morbidity and medical costs, using data from the Korea National Health Insurance Claims Database of the Health Insurance Review and Assessment Service. Methods Delivery cases in 2010, 2011 and 2012 (459 842, 442 225 and 380 431 deliveries) were extracted from the Health Insurance Review and Assessment Service database. The complications and medical costs were compared among the following three pregnancy groups: normal, gestational diabetes and pre-existing diabetes. Results Although, the rates of pre-existing diabetes did not fluctuate (2.5, 2.4 and 2.7%) throughout the study, the rate of gestational diabetes steadily increased (4.6, 6.2 and 8.0%). Furthermore, the rates of pre-existing diabetes and gestational diabetes increased in conjunction with maternal age, pre-existing hypertension and cases of multiple pregnancy. The risk of pregnancy-induced hypertension, urinary tract infections, premature delivery, liver disease and chronic renal disease were greater in the gestational diabetes and pre-existing diabetes groups than in the normal group. The risk of venous thromboembolism, antepartum haemorrhage, shoulder dystocia and placenta disorder were greater in the pre-existing diabetes group, but not the gestational diabetes group, compared with the normal group. The medical costs associated with delivery, the costs during pregnancy and the number of in-hospital days for the subjects in the pre-existing diabetes group were the highest among the three groups. Conclusions The study showed that the rates of pre-existing diabetes and gestational diabetes increased with maternal age at pregnancy and were associated with increases in medical costs and pregnancy-related complications. PMID:25472691

40 CFR 63.1157 - Emission standards for existing sources.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Facilities and Hydrochloric Acid Regeneration Plants § 63.1157 Emission standards for existing sources. (a... percent. (b) Hydrochloric acid regeneration plants. (1) No owner or operator of an existing affected plant...

40 CFR 63.1157 - Emission standards for existing sources.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Facilities and Hydrochloric Acid Regeneration Plants § 63.1157 Emission standards for existing sources. (a... percent. (b) Hydrochloric acid regeneration plants. (1) No owner or operator of an existing affected plant...

40 CFR 63.1157 - Emission standards for existing sources.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Facilities and Hydrochloric Acid Regeneration Plants § 63.1157 Emission standards for existing sources. (a... percent. (b) Hydrochloric acid regeneration plants. (1) No owner or operator of an existing affected plant...

40 CFR 63.1157 - Emission standards for existing sources.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Facilities and Hydrochloric Acid Regeneration Plants § 63.1157 Emission standards for existing sources. (a... percent. (b) Hydrochloric acid regeneration plants. (1) No owner or operator of an existing affected plant...

14 CFR § 1203.604 - Mandatory review for declassification.

Code of Federal Regulations, 2014 CFR

2014-01-01

...) Presidential papers. Information originated by the President or Vice President; the President's White House... confirm or deny the existence or non-existence of requested information whenever the fact of its existence...

40 CFR 63.1500 - Applicability.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) Each new and existing group 2 furnace; (5) Each new and existing sweat furnace; (6) Each new and... scrap dryer/delacquering kiln/decoating kiln; (3) Each new and existing sweat furnace; (4) Each new and...

40 CFR 63.1500 - Applicability.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) Each new and existing group 2 furnace; (5) Each new and existing sweat furnace; (6) Each new and... scrap dryer/delacquering kiln/decoating kiln; (3) Each new and existing sweat furnace; (4) Each new and...

40 CFR 63.1500 - Applicability.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) Each new and existing group 2 furnace; (5) Each new and existing sweat furnace; (6) Each new and... scrap dryer/delacquering kiln/decoating kiln; (3) Each new and existing sweat furnace; (4) Each new and...

40 CFR 63.1500 - Applicability.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) Each new and existing group 2 furnace; (5) Each new and existing sweat furnace; (6) Each new and... scrap dryer/delacquering kiln/decoating kiln; (3) Each new and existing sweat furnace; (4) Each new and...

40 CFR 63.1500 - Applicability.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) Each new and existing group 2 furnace; (5) Each new and existing sweat furnace; (6) Each new and... scrap dryer/delacquering kiln/decoating kiln; (3) Each new and existing sweat furnace; (4) Each new and...

40 CFR 463.35 - Pretreatment standards for existing sources.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Subcategory § 463.35 Pretreatment standards for existing sources. (a) PSES for bis(2-ethylhexyl) phthalate, di-n-butyl phthalate, and dimethyl phthalate are reserved. (b) Any existing source subject to this...

40 CFR 62.1350 - Identification of plan.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Emissions from Existing Municipal Solid Waste Landfills § 62.1350 Identification of plan. “111(d) Plan for Existing Municipal Solid Waste Landfills Existing in Colorado” and the associated State regulations in Part...

Evaluating existing access opportunities for disabled persons at remote shoreline recreation sites

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bley, M.R.; Kearns, M.T.

1995-12-31

Draft guidelines for providing outdoor recreation access opportunities for disabled persons have been recommended by the Recreation Access Advisory Committee and in the Universal Access to Outdoor Recreation: A Design Guide. The Federal Energy Regulatory Commission requires applicants for new hydropower licenses to consider access opportunities for disabled persons at existing hydropower projects. A process for evaluating existing access opportunities for disabled persons at remote shoreline recreation sites at hydropower projects is described. The process includes five steps: (1) preparing a preliminary map of existing recreation sites; (2) data collection in the field; (3) evaluating compliance of existing facilities; (4)more » feasibility of enhancing existing facilities; and (5) designing enhancements. The process will be refined when final standards and processes are approved by the appropriate agencies and organizations.« less

40 CFR 63.6604 - What fuel requirements must I meet if I own or operate an existing stationary CI RICE?

Code of Federal Regulations, 2010 CFR

2010-07-01

... I own or operate an existing stationary CI RICE? 63.6604 Section 63.6604 Protection of Environment....6604 What fuel requirements must I meet if I own or operate an existing stationary CI RICE? If you own or operate an existing non-emergency CI stationary RICE with a site rating of more than 300 brake HP...

40 CFR 63.6603 - What emission limitations and operating limitations must I meet if I own or operate an existing...

Code of Federal Regulations, 2011 CFR

2011-07-01

... operating limitations must I meet if I own or operate an existing stationary RICE located at an area source... operating limitations must I meet if I own or operate an existing stationary RICE located at an area source... procedures in § 63.6620 and Table 4 to this subpart. (a) If you own or operate an existing stationary RICE...

26 CFR 54.4977-1T - Questions and answers relating to the election concerning lines of business in existence on...

Code of Federal Regulations, 2010 CFR

2010-04-01

... business in existence on January 1, 1984, as employees of one of those lines of business for purposes of... were in existence on January 1, 1984, as employees of one of those lines of business for purposes of... concerning lines of business in existence on January 1, 1984 (temporary). 54.4977-1T Section 54.4977-1T...

26 CFR 54.4977-1T - Questions and answers relating to the election concerning lines of business in existence on...

Code of Federal Regulations, 2011 CFR

2011-04-01

... business in existence on January 1, 1984, as employees of one of those lines of business for purposes of... were in existence on January 1, 1984, as employees of one of those lines of business for purposes of... concerning lines of business in existence on January 1, 1984 (temporary). 54.4977-1T Section 54.4977-1T...

Pre-existing immunity against Ad vectors: humoral, cellular, and innate response, what's important?.

PubMed

Fausther-Bovendo, Hugues; Kobinger, Gary P

2014-01-01

Pre-existing immunity against human adenovirus (HAd) serotype 5 derived vector in the human population is widespread, thus hampering its clinical use. Various components of the immune system, including neutralizing antibodies (nAbs), Ad specific T cells and type I IFN activated NK cells, contribute to dampening the efficacy of Ad vectors in individuals with pre-existing Ad immunity. In order to circumvent pre-existing immunity to adenovirus, numerous strategies, such as developing alternative Ad serotypes, varying immunization routes and utilizing prime-boost regimens, are under pre-clinical or clinical phases of development. However, these strategies mainly focus on one arm of pre-existing immunity. Selection of alternative serotypes has been largely driven by the absence in the human population of nAbs against them with little attention paid to cross-reactive Ad specific T cells. Conversely, varying the route of immunization appears to mainly rely on avoiding Ad specific tissue-resident T cells. Finally, prime-boost regimens do not actually circumvent pre-existing immunity but instead generate immune responses of sufficient magnitude to confer protection despite pre-existing immunity. Combining the above strategies and thus taking into account all components regulating pre-existing Ad immunity will help further improve the development of Ad vectors for animal and human use.

Effectiveness of two reflection crack attenuation techniques.

DOT National Transportation Integrated Search

2015-09-01

Asphalt overlays are one of the most common tools for rehabilitating existing asphalt and concrete pavements. : However, the performance of new overlays is often jeopardized by the cracking distress in the existing : pavement. This existing cracking ...

Seniors' experiences of living in special housing accommodation

PubMed Central

Hellberg, Ingela; Augustsson, Veronica; Hellström Muhli, Ulla

2011-01-01

This article presents a hermeneutic phenomenological analysis of interview material in which 12 seniors living in Special Housing Accommodation (SHA) facilities reflect on the experience of living in such facilities. Of particular interest in the analysis is living in a SHA as a phenomenon. The finding shows that the phenomenon of lived experience in a SHA seems to be a state of ambiguity regarding one's existence, which is made up of several constituents (elements of meaning). The analysis contributes to the understanding of how the phenomenon of SHA living is coming into existence as a need, due to an individual's failing health; however, the SHA is not considered to be a true home. Accordingly, this has consequences to the subject position for the seniors in that they have to navigate between existing and not existing. The seniors learn to cope with living in the SHA by lowering their expectations of life and existence while the SHA provides the prerequisites for their existence. An implication for promoting care is to support the seniors to enable a full existence of life within SHA living. PMID:21412446

Cost-effective treatment of existing guardrail systems.

DOT National Transportation Integrated Search

2013-05-01

A cost-effective means for upgrading existing guardrail systems with deviations from current practice (i.e., low-rail heights, antiquated end : treatments, and improper installation) does not exist. As a result these systems remain on U.S. highways. ...

Cost/Value Approach to Insulation Produces Savings at Sibley School

ERIC Educational Resources Information Center

School Business Affairs, 1978

1978-01-01

An energy savings study revealed that adding insulation to an existing building and reducing ventilation loads would enable the school to heat both the existing building and the addition with existing boiler equipment. (Author/MLF)

Survey of Existing Uncertainty Quantification Capabilities for Army Relevant Problems

DTIC Science & Technology

2017-11-27

ARL-TR-8218•NOV 2017 US Army Research Laboratory Survey of Existing Uncertainty Quantification Capabilities for Army-Relevant Problems by James J...NOV 2017 US Army Research Laboratory Survey of Existing Uncertainty Quantification Capabilities for Army-Relevant Problems by James J Ramsey...Rev. 8/98)    Prescribed by ANSI Std. Z39.18 November 2017 Technical Report Survey of Existing Uncertainty Quantification Capabilities for Army

40 CFR 63.6602 - What emission limitations must I meet if I own or operate an existing stationary CI RICE with a...

Code of Federal Regulations, 2010 CFR

2010-07-01

... if I own or operate an existing stationary CI RICE with a site rating of equal to or less than 500....6602 What emission limitations must I meet if I own or operate an existing stationary CI RICE with a... own or operate an existing stationary CI RICE with a site rating of equal to or less than 500 brake HP...

40 CFR 63.6602 - What emission limitations must I meet if I own or operate an existing stationary RICE with a site...

Code of Federal Regulations, 2011 CFR

2011-07-01

... if I own or operate an existing stationary RICE with a site rating of equal to or less than 500 brake....6602 What emission limitations must I meet if I own or operate an existing stationary RICE with a site... operate an existing stationary RICE with a site rating of equal to or less than 500 brake HP located at a...

Radiological protection from radioactive waste management in existing exposure situations resulting from a nuclear accident.

PubMed

Sugiyama, Daisuke; Hattori, Takatoshi

2013-01-01

In environmental remediation after nuclear accidents, radioactive wastes have to be appropriately managed in existing exposure situations with contamination resulting from the emission of radionuclides by such accidents. In this paper, a framework of radiation protection from radioactive waste management in existing exposure situations for application to the practical and reasonable waste management in contaminated areas, referring to related ICRP recommendations was proposed. In the proposed concept, intermediate reference levels for waste management are adopted gradually according to the progress of the reduction in the existing ambient dose in the environment on the basis of the principles of justification and optimisation by taking into account the practicability of the management of radioactive waste and environmental remediation. It is essential to include the participation of relevant stakeholders living in existing exposure situations in the selection of reference levels for the existing ambient dose and waste management.

Radiological protection from radioactive waste management in existing exposure situations resulting from a nuclear accident

PubMed Central

Sugiyama, Daisuke; Hattori, Takatoshi

2013-01-01

In environmental remediation after nuclear accidents, radioactive wastes have to be appropriately managed in existing exposure situations with contamination resulting from the emission of radionuclides by such accidents. In this paper, a framework of radiation protection from radioactive waste management in existing exposure situations for application to the practical and reasonable waste management in contaminated areas, referring to related ICRP recommendations was proposed. In the proposed concept, intermediate reference levels for waste management are adopted gradually according to the progress of the reduction in the existing ambient dose in the environment on the basis of the principles of justification and optimisation by taking into account the practicability of the management of radioactive waste and environmental remediation. It is essential to include the participation of relevant stakeholders living in existing exposure situations in the selection of reference levels for the existing ambient dose and waste management. PMID:22719047

Method of making an aero-derivative gas turbine engine

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wiebe, David J.

A method of making an aero-derivative gas turbine engine (100) is provided. A combustor outer casing (68) is removed from an existing aero gas turbine engine (60). An annular combustor (84) is removed from the existing aero gas turbine engine. A first row of turbine vanes (38) is removed from the existing aero gas turbine engine. A can annular combustor assembly (122) is installed within the existing aero gas turbine engine. The can annular combustor assembly is configured to accelerate and orient combustion gasses directly onto a first row of turbine blades of the existing aero gas turbine engine. Amore » can annular combustor assembly outer casing (108) is installed to produce the aero-derivative gas turbine engine (100). The can annular combustor assembly is installed within an axial span (85) of the existing aero gas turbine engine vacated by the annular combustor and the first row of turbine vanes.« less

Integrating Clinical Neuropsychology into the Undergraduate Curriculum.

ERIC Educational Resources Information Center

Puente, Antonio E.; And Others

1991-01-01

Claims little information exists in undergraduate education about clinical neuropsychology. Outlines an undergraduate neuropsychology course and proposes ways to integrate the subject into existing undergraduate psychology courses. Suggests developing specialized audio-visual materials for telecourses or existing courses. (NL)

40 CFR 415.554 - Pretreatment standards for existing sources (PSES).

Code of Federal Regulations, 2010 CFR

2010-07-01

... Fluoride Production Subcategory § 415.554 Pretreatment standards for existing sources (PSES). Except as... pretreatment standards for existing sources (PSES): Subpart BC—Sodium Fluoride Pollution or pollutant property... Milligrams per liter (mg/l) Fluoride 50 25 ...

40 CFR 415.554 - Pretreatment standards for existing sources (PSES).

Code of Federal Regulations, 2011 CFR

2011-07-01

... Fluoride Production Subcategory § 415.554 Pretreatment standards for existing sources (PSES). Except as... pretreatment standards for existing sources (PSES): Subpart BC—Sodium Fluoride Pollution or pollutant property... Milligrams per liter (mg/l) Fluoride 50 25 ...

40 CFR 62.7455 - Identification of sources.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Air Emissions from Existing Commercial and Industrial Solid Waste Incineration Units § 62.7455 Identification of sources. (a) The plan applies to the following existing commercial and solid waste incineration...] Air Emissions From Existing Large and Small Municipal Waste Combustors ...

40 CFR 62.7455 - Identification of sources.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Air Emissions from Existing Commercial and Industrial Solid Waste Incineration Units § 62.7455 Identification of sources. (a) The plan applies to the following existing commercial and solid waste incineration...] Air Emissions From Existing Large and Small Municipal Waste Combustors ...

40 CFR 62.1115 - Identification of sources.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Landfill Gas Emissions from Existing Municipal Solid Waste Landfills § 62.1115 Identification of sources. The plan applies to existing municipal solid waste landfills for which construction, reconstruction... 51451, Sept. 23, 1999] Emissions From Small Existing Municipal Waste Combustion Units ...

Topological constraints and the existence of force-free fields

NASA Technical Reports Server (NTRS)

Antiochos, S. K.

1986-01-01

A fundamental problem in plasma theory is the question of the existence of MHD equilibria. The issue of topological constraints is of crucial importance for the problem of the existence of equilibria. Heuristic methods are used to discuss the coronal wrapping pattern. It is concluded that for a given set of footpoint positions the wrapping pattern in the corona is completely fixed. The topological constraints are included in the boundary conditions on the Euler potentials and impost no additional restrictions on possible equilibria. Although this does not prove that equilibria always exist, it does show that the force-free problem is not overdetermined and that existence of equilibria is still an open question.

Existence of equilibria in articulated bearings

NASA Astrophysics Data System (ADS)

Buscaglia, G.; Ciuperca, I.; Hafidi, I.; Jai, M.

2007-04-01

The existence of equilibrium solutions for a lubricated system consisting of an articulated body sliding over a flat plate is considered. Though this configuration is very common (it corresponds to the popular tilting-pad thrust bearings), the existence problem has only been addressed in extremely simplified cases, such as planar sliders of infinite width. Our results show the existence of at least one equilibrium for a quite general class of (nonplanar) slider shapes. We also extend previous results concerning planar sliders.

47 CFR 54.604 - Existing contracts.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES (CONTINUED) UNIVERSAL SERVICE Universal Service Support for Health Care Providers § 54.604 Existing contracts. (a) Existing... health care provider as defined under § 54.601 and a telecommunications carrier shall be exempt from the...

Unmanned launch vehicle impacts on existing major facilities : V23

DOT National Transportation Integrated Search

1984-10-18

This study measures the impact on the existing major facilities of Space Launch Complex (SLC-6) to accommodate the launching of an Unmanned Launch Vehicle (ULV). Modifications to the existing facilities were determined for two basic vehicle concepts,...

Does Informal Employment Exist in the United States and Other Developed Countries?

PubMed

Siqueira, Carlos E

2016-08-01

This editorial argues that informal employment does exist in developed countries and needs to be studied as such to complement the existing literature mostly published on informal work in developing countries. © The Author(s) 2016.

45 CFR 84.22 - Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., welfare, or other social services at alternate accessible sites, alteration of existing facilities and... to make structural changes in existing facilities where other methods are effective in achieving... handicapped persons in the most integrated setting appropriate. (c) Small health, welfare, or other social...

40 CFR 62.4178 - Identification of plan.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Existing Municipal Solid Waste Landfills § 62.4178 Identification of plan. (a) Identification of plan. Kansas plan for control of landfill gas emissions from existing municipal solid waste landfills and... to all existing municipal solid waste landfills for which construction, reconstruction, or...

45 CFR 84.22 - Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., welfare, or other social services at alternate accessible sites, alteration of existing facilities and... to make structural changes in existing facilities where other methods are effective in achieving... handicapped persons in the most integrated setting appropriate. (c) Small health, welfare, or other social...

Study of structural reliability of existing concrete structures

NASA Astrophysics Data System (ADS)

Druķis, P.; Gaile, L.; Valtere, K.; Pakrastiņš, L.; Goremikins, V.

2017-10-01

Structural reliability of buildings has become an important issue after the collapse of a shopping center in Riga 21.11.2013, caused the death of 54 people. The reliability of a building is the practice of designing, constructing, operating, maintaining and removing buildings in ways that ensure maintained health, ward suffered injuries or death due to use of the building. Evaluation and improvement of existing buildings is becoming more and more important. For a large part of existing buildings, the design life has been reached or will be reached in the near future. The structures of these buildings need to be reassessed in order to find out whether the safety requirements are met. The safety requirements provided by the Eurocodes are a starting point for the assessment of safety. However, it would be uneconomical to require all existing buildings and structures to comply fully with these new codes and corresponding safety levels, therefore the assessment of existing buildings differs with each design situation. This case study describes the simple and practical procedure of determination of minimal reliability index β of existing concrete structures designed by different codes than Eurocodes and allows to reassess the actual reliability level of different structural elements of existing buildings under design load.

77 FR 47572 - Retrospective Analysis of Existing Rules

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-09

... INTERNATIONAL TRADE COMMISSION 19 CFR Chapter II Retrospective Analysis of Existing Rules AGENCY... Order 13579 of July 11, 2011, the Commission recently adopted its Plan for Retrospective Analysis of... submitted in connection with the Commission's Preliminary Plan for Retrospective Analysis of Existing Rules...

43 CFR 404.53 - Does this rule provide authority for the transfer of pre-existing facilities from Federal to...

Code of Federal Regulations, 2010 CFR

2010-10-01

... RECLAMATION, DEPARTMENT OF THE INTERIOR RECLAMATION RURAL WATER SUPPLY PROGRAM Miscellaneous § 404.53 Does...-existing facilities or pre-existing components of any water system from Federal to private ownership, or...

77 FR 3763 - Town of Canton; Notice of Preliminary Permit Application Accepted for Filing and Soliciting...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-25

... existing brick and masonry powerhouse with two new turbine generating units with a total installed capacity... existing 650-foot-long, 50-foot-wide intake canal; (6) an existing brick and masonry powerhouse with two...

Installation of Existing Lift Systems for the Handicapped on Light Rail Vehicles

DOT National Transportation Integrated Search

1985-05-01

This report documents the results of a three-phase program to install an existing transit bus wheelchair lift system on a Boeing Light Rail Vehicle (LRV). Program activities included a review of lift requirements, evaluation of existing lift systems,...

32 CFR 651.38 - Existing environmental assessments.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 4 2011-07-01 2011-07-01 false Existing environmental assessments. 651.38...) ENVIRONMENTAL QUALITY ENVIRONMENTAL ANALYSIS OF ARMY ACTIONS (AR 200-2) Environmental Assessment § 651.38 Existing environmental assessments. EAs are dynamic documents. To ensure that the described setting...

33 CFR 175.135 - Existing equipment.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Existing equipment. 175.135 Section 175.135 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) BOATING SAFETY EQUIPMENT REQUIREMENTS Visual Distress Signals § 175.135 Existing equipment. Launchers...

33 CFR 175.135 - Existing equipment.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 2 2012-07-01 2012-07-01 false Existing equipment. 175.135 Section 175.135 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) BOATING SAFETY EQUIPMENT REQUIREMENTS Visual Distress Signals § 175.135 Existing equipment. Launchers...

33 CFR 175.135 - Existing equipment.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 2 2014-07-01 2014-07-01 false Existing equipment. 175.135 Section 175.135 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) BOATING SAFETY EQUIPMENT REQUIREMENTS Visual Distress Signals § 175.135 Existing equipment. Launchers...

33 CFR 175.135 - Existing equipment.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 2 2013-07-01 2013-07-01 false Existing equipment. 175.135 Section 175.135 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) BOATING SAFETY EQUIPMENT REQUIREMENTS Visual Distress Signals § 175.135 Existing equipment. Launchers...

33 CFR 175.135 - Existing equipment.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Existing equipment. 175.135 Section 175.135 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) BOATING SAFETY EQUIPMENT REQUIREMENTS Visual Distress Signals § 175.135 Existing equipment. Launchers...

47 CFR 54.604 - Consortia, telecommunications services, and existing contracts.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 3 2014-10-01 2014-10-01 false Consortia, telecommunications services, and existing contracts. 54.604 Section 54.604 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED... Telecommunications Program § 54.604 Consortia, telecommunications services, and existing contracts. (a) Consortia. (1...

47 CFR 54.604 - Consortia, telecommunications services, and existing contracts.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 3 2013-10-01 2013-10-01 false Consortia, telecommunications services, and existing contracts. 54.604 Section 54.604 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED... Telecommunications Program § 54.604 Consortia, telecommunications services, and existing contracts. (a) Consortia. (1...

A compendium of existing HOV lane facilities in the United States

DOT National Transportation Integrated Search

2008-12-01

The compendium provides an assembly of available information on existing HOV lane facilities in the United States. While it is comprehensive and thought to include virtually all existing facilities at this time, it is possible that there are isolated...

The Existence of Periodic Orbits and Invariant Tori for Some 3-Dimensional Quadratic Systems

PubMed Central

Jiang, Yanan; Han, Maoan; Xiao, Dongmei

2014-01-01

We use the normal form theory, averaging method, and integral manifold theorem to study the existence of limit cycles in Lotka-Volterra systems and the existence of invariant tori in quadratic systems in ℝ3. PMID:24982980

15 CFR 12.2 - Undue proliferation.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., he shall initiate an inquiry for the purpose of finding facts concerning the existence of undue... possible existence of undue proliferation. Such communications should be in writing and include supporting... regarding the possible existence of undue proliferation, the Secretary will determine whether there has been...

20 CFR 718.305 - Presumption of pneumoconiosis.

Code of Federal Regulations, 2011 CFR

2011-04-01

... existence of a totally disabling respiratory or pulmonary impairment, for purposes of applying the... other evidence demonstrates the existence of a totally disabling respiratory or pulmonary impairment... the miner's condition shall be considered to be sufficient to establish the existence of a totally...

20 CFR 718.305 - Presumption of pneumoconiosis.

Code of Federal Regulations, 2010 CFR

2010-04-01

... existence of a totally disabling respiratory or pulmonary impairment, for purposes of applying the... other evidence demonstrates the existence of a totally disabling respiratory or pulmonary impairment... the miner's condition shall be considered to be sufficient to establish the existence of a totally...

15 CFR 12.2 - Undue proliferation.

Code of Federal Regulations, 2011 CFR

2011-01-01

..., he shall initiate an inquiry for the purpose of finding facts concerning the existence of undue... possible existence of undue proliferation. Such communications should be in writing and include supporting... regarding the possible existence of undue proliferation, the Secretary will determine whether there has been...

40 CFR 63.11415 - What are my compliance dates?

Code of Federal Regulations, 2011 CFR

2011-07-01

...) National Emission Standards for Hazardous Air Pollutants for Flexible Polyurethane Foam Production and... you own or operate an existing slabstock flexible polyurethane foam production affected source, you... or operate an existing molded flexible polyurethane foam affected source, an existing rebond foam...

40 CFR 63.11415 - What are my compliance dates?

Code of Federal Regulations, 2012 CFR

2012-07-01

...) National Emission Standards for Hazardous Air Pollutants for Flexible Polyurethane Foam Production and... you own or operate an existing slabstock flexible polyurethane foam production affected source, you... or operate an existing molded flexible polyurethane foam affected source, an existing rebond foam...

40 CFR 63.11415 - What are my compliance dates?

Code of Federal Regulations, 2010 CFR

2010-07-01

...) National Emission Standards for Hazardous Air Pollutants for Flexible Polyurethane Foam Production and... you own or operate an existing slabstock flexible polyurethane foam production affected source, you... or operate an existing molded flexible polyurethane foam affected source, an existing rebond foam...

40 CFR 63.11415 - What are my compliance dates?

Code of Federal Regulations, 2013 CFR

2013-07-01

...) National Emission Standards for Hazardous Air Pollutants for Flexible Polyurethane Foam Production and... you own or operate an existing slabstock flexible polyurethane foam production affected source, you... or operate an existing molded flexible polyurethane foam affected source, an existing rebond foam...

40 CFR 63.11415 - What are my compliance dates?

Code of Federal Regulations, 2014 CFR

2014-07-01

...) National Emission Standards for Hazardous Air Pollutants for Flexible Polyurethane Foam Production and... you own or operate an existing slabstock flexible polyurethane foam production affected source, you... or operate an existing molded flexible polyurethane foam affected source, an existing rebond foam...

5 CFR 9701.506 - Impact on existing agreements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Impact on existing agreements. 9701.506 Section 9701.506 Administrative Personnel DEPARTMENT OF HOMELAND SECURITY HUMAN RESOURCES MANAGEMENT... HUMAN RESOURCES MANAGEMENT SYSTEM Labor-Management Relations § 9701.506 Impact on existing agreements...

34 CFR 104.22 - Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., delivery of health, welfare, or other social services at alternate accessible sites, alteration of existing... not required to make structural changes in existing facilities where other methods are effective in... handicapped persons in the most integrated setting appropriate. (c) Small health, welfare, or other social...

40 CFR 421.95 - Pretreatment standards for existing sources.

Code of Federal Regulations, 2013 CFR

2013-07-01

... standards for existing sources. The mass of wastewater pollutants in metallurgical acid plant blowdown... 40 Protection of Environment 30 2013-07-01 2012-07-01 true Pretreatment standards for existing...) EFFLUENT GUIDELINES AND STANDARDS NONFERROUS METALS MANUFACTURING POINT SOURCE CATEGORY Metallurgical Acid...

Geometric criteria for the non-existence of cycles in predator-prey systems with group defense.

PubMed

Liu, Yaping

2007-07-01

In this paper, we study the existence of cycles in a predator-prey system in which the prey species is equipped with the group defense capability. Some geometric criteria are developed, relating the location of the two positive equilibria on the prey isocline and the non-existence of cycles. We show that under a general geometric condition, if both positive equilibria lie on a downslope or both lie on an upslope of the prey isocline, cycles do not exist.

[Alcoholism and the aesthetics of existence: Jack London and the white logic of John Barleycorn].

PubMed

Arantes, Marco Antonio

2015-12-01

Employing this theme as a guideline, this article examines how his prose amounts to self-practice in the construction of subjectivity and the organization of existence. It investigates how this work is related to the theme of self-care, analyzed by Michel Foucault in volumes 2 and 3 of the History of sexuality, as regards the aesthetics of existence and the art of living which existed in the Greco-Roman and Hellenistic worlds.

Evaluation of pre-existing antibody presence as a risk factor for posttreatment anti-drug antibody induction: analysis of human clinical study data for multiple biotherapeutics.

PubMed

Xue, Li; Rup, Bonita

2013-07-01

Biotherapeutic-reactive antibodies in treatment-naïve subjects (i.e., pre-existing antibodies) have been commonly detected during clinical immunogenicity assessments; however information on pre-existing antibody prevalence, physiological effects, and impact on posttreatment anti-drug antibody (ADA) induction remains limited. In this analysis, pre-existing antibody prevalence and impact on posttreatment ADA induction were determined using ADA data from 12 biotherapeutics analyzed in 32 clinical studies. Approximately half (58%) of the biotherapeutics were associated with some level of pre-existing antibodies and 67% of those were associated with posttreatment ADA induction. Across all studies, 5.6% of study subjects demonstrated presence of pre-existing antibodies, among which, 17% of the individual subjects had posttreatment increases in their ADA titers while 16% had decreased titers and 67% had no change in titers. However, in studies conducted in the rheumatoid arthritis (RA) population, 14.8% of RA patients were associated with pre-existing antibodies and 30% of those had posttreatment titer increases. The results suggest that in most study subjects, pre-existing antibodies pose a low risk for posttreatment ADA induction. That said, the high risk of induction implicated for RA patients, primarily observed in treatments evaluating novel antibody-based constructs, indicates that further understanding of the contribution of product and disease-specific factors is needed. Cross-industry efforts to collect and analyze a larger data set would enhance understanding of the prevalence, nature, and physiological consequences of pre-existing antibodies, better inform the immunogenicity risk profiles of products associated with these antibodies and lead to better fit-for-purpose immunogenicity management and mitigation strategies.

Existence of infinitely many stationary solutions of the L2-subcritical and critical NLSE on compact metric graphs

NASA Astrophysics Data System (ADS)

Dovetta, Simone

2018-04-01

We investigate the existence of stationary solutions for the nonlinear Schrödinger equation on compact metric graphs. In the L2-subcritical setting, we prove the existence of an infinite number of such solutions, for every value of the mass. In the critical regime, the existence of infinitely many solutions is established if the mass is lower than a threshold value, while global minimizers of the NLS energy exist if and only if the mass is lower or equal to the threshold. Moreover, the relation between this threshold and the topology of the graph is characterized. The investigation is based on variational techniques and some new versions of Gagliardo-Nirenberg inequalities.

Existence and asymptotic behavior of nontrivial solutions to the Swift-Hohenberg equation

NASA Astrophysics Data System (ADS)

Marino, G.; Mosconi, S.

2017-12-01

In this paper, we discuss several results regarding existence, non-existence and asymptotic properties of solutions to u⁗ + qu″ + f (u) = 0, under various hypotheses on the parameter q and on the potential F (t) = ∫0t f (s) ds, generally assumed to be bounded from below. We prove a non-existence result in the case q ≤ 0 and an existence result of periodic solution for: 1) almost every suitably small (depending on F), positive values of q; 2) all suitably large (depending on F) values of q. Finally, we describe some conditions on F which ensure that some (or all) solutions uq to the equation satisfy ‖uq‖∞ → 0, as q ↓ 0.

19 CFR 201.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 19 Customs Duties 3 2010-04-01 2010-04-01 false Program accessibility: Existing facilities. 201.150 Section 201.150 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF... Conducted by the U.S. International Trade Commission § 201.150 Program accessibility: Existing facilities...

19 CFR 201.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 19 Customs Duties 3 2012-04-01 2012-04-01 false Program accessibility: Existing facilities. 201.150 Section 201.150 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF... Conducted by the U.S. International Trade Commission § 201.150 Program accessibility: Existing facilities...

19 CFR 201.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 19 Customs Duties 3 2014-04-01 2014-04-01 false Program accessibility: Existing facilities. 201.150 Section 201.150 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF... Conducted by the U.S. International Trade Commission § 201.150 Program accessibility: Existing facilities...

19 CFR 201.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 19 Customs Duties 3 2013-04-01 2013-04-01 false Program accessibility: Existing facilities. 201.150 Section 201.150 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF... Conducted by the U.S. International Trade Commission § 201.150 Program accessibility: Existing facilities...

19 CFR 201.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 19 Customs Duties 3 2011-04-01 2011-04-01 false Program accessibility: Existing facilities. 201.150 Section 201.150 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION GENERAL RULES OF... Conducted by the U.S. International Trade Commission § 201.150 Program accessibility: Existing facilities...

49 CFR 223.15 - Requirements for existing passenger cars.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Requirements for existing passenger cars. 223.15... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION SAFETY GLAZING STANDARDS-LOCOMOTIVES, PASSENGER CARS AND CABOOSES Specific Requirements § 223.15 Requirements for existing passenger cars. (a) Passenger cars built or...

49 CFR 223.15 - Requirements for existing passenger cars.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 4 2014-10-01 2014-10-01 false Requirements for existing passenger cars. 223.15... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION SAFETY GLAZING STANDARDS-LOCOMOTIVES, PASSENGER CARS AND CABOOSES Specific Requirements § 223.15 Requirements for existing passenger cars. (a) Passenger cars built or...

49 CFR 223.15 - Requirements for existing passenger cars.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 4 2011-10-01 2011-10-01 false Requirements for existing passenger cars. 223.15... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION SAFETY GLAZING STANDARDS-LOCOMOTIVES, PASSENGER CARS AND CABOOSES Specific Requirements § 223.15 Requirements for existing passenger cars. (a) Passenger cars built or...

49 CFR 223.15 - Requirements for existing passenger cars.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 4 2012-10-01 2012-10-01 false Requirements for existing passenger cars. 223.15... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION SAFETY GLAZING STANDARDS-LOCOMOTIVES, PASSENGER CARS AND CABOOSES Specific Requirements § 223.15 Requirements for existing passenger cars. (a) Passenger cars built or...

49 CFR 223.15 - Requirements for existing passenger cars.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 4 2013-10-01 2013-10-01 false Requirements for existing passenger cars. 223.15... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION SAFETY GLAZING STANDARDS-LOCOMOTIVES, PASSENGER CARS AND CABOOSES Specific Requirements § 223.15 Requirements for existing passenger cars. (a) Passenger cars built or...

40 CFR 52.939 - Original identification of plan section.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Performance for Existing Solvent Metal Cleaning Equipment. (7) Regulation 6.19 Standard of Performance for Existing Metal Furniture Surface Coating Operations. (8) Regulation 6.23 Standard of Performance for...) Regulation 6.31 Standard of Performance for Existing Miscellaneous Metal Parts and Products Surface Coating...

40 CFR 52.939 - Original identification of plan section.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Performance for Existing Solvent Metal Cleaning Equipment. (7) Regulation 6.19 Standard of Performance for Existing Metal Furniture Surface Coating Operations. (8) Regulation 6.23 Standard of Performance for...) Regulation 6.31 Standard of Performance for Existing Miscellaneous Metal Parts and Products Surface Coating...

40 CFR 52.939 - Original identification of plan section.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Performance for Existing Solvent Metal Cleaning Equipment. (7) Regulation 6.19 Standard of Performance for Existing Metal Furniture Surface Coating Operations. (8) Regulation 6.23 Standard of Performance for...) Regulation 6.31 Standard of Performance for Existing Miscellaneous Metal Parts and Products Surface Coating...

14 CFR 1251.301 - Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-01-01

... HANDICAP Accessibility § 1251.301 Existing facilities. (a) Accessibility. A recipient shall operate each... readily accessible to handicapped persons. This paragraph does not require a recipient to make each of its existing facilities or every part of a facility accessible to and usable by handicapped persons. (b...

14 CFR 1251.301 - Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... HANDICAP Accessibility § 1251.301 Existing facilities. (a) Accessibility. A recipient shall operate each... readily accessible to handicapped persons. This paragraph does not require a recipient to make each of its existing facilities or every part of a facility accessible to and usable by handicapped persons. (b...

14 CFR 1251.301 - Existing facilities.

Code of Federal Regulations, 2013 CFR

2013-01-01

... HANDICAP Accessibility § 1251.301 Existing facilities. (a) Accessibility. A recipient shall operate each... readily accessible to handicapped persons. This paragraph does not require a recipient to make each of its existing facilities or every part of a facility accessible to and usable by handicapped persons. (b...

14 CFR 1251.301 - Existing facilities.

Code of Federal Regulations, 2012 CFR

2012-01-01

... HANDICAP Accessibility § 1251.301 Existing facilities. (a) Accessibility. A recipient shall operate each... readily accessible to handicapped persons. This paragraph does not require a recipient to make each of its existing facilities or every part of a facility accessible to and usable by handicapped persons. (b...

Existence of tripled fixed points for a class of condensing operators in Banach spaces.

PubMed

Karakaya, Vatan; Bouzara, Nour El Houda; Doğan, Kadri; Atalan, Yunus

2014-01-01

We give some results concerning the existence of tripled fixed points for a class of condensing operators in Banach spaces. Further, as an application, we study the existence of solutions for a general system of nonlinear integral equations.

45 CFR 2301.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 4 2010-10-01 2010-10-01 false Program accessibility: Existing facilities. 2301.150 Section 2301.150 Public Welfare Regulations Relating to Public Welfare (Continued) ARCTIC RESEARCH... THE UNITED STATES ARCTIC RESEARCH COMMISSION § 2301.150 Program accessibility: Existing facilities. (a...

45 CFR 2301.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 4 2011-10-01 2011-10-01 false Program accessibility: Existing facilities. 2301.150 Section 2301.150 Public Welfare Regulations Relating to Public Welfare (Continued) ARCTIC RESEARCH... THE UNITED STATES ARCTIC RESEARCH COMMISSION § 2301.150 Program accessibility: Existing facilities. (a...

40 CFR 415.474 - Pretreatment standards for existing sources (PSES).

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 30 2012-07-01 2012-07-01 false Pretreatment standards for existing... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS INORGANIC CHEMICALS MANUFACTURING POINT SOURCE CATEGORY Nickel Salts Production Subcategory § 415.474 Pretreatment standards for existing sources (PSES). (a) Except as...

40 CFR 415.364 - Pretreatment standards for existing sources (PSES).

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 30 2013-07-01 2012-07-01 true Pretreatment standards for existing... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS INORGANIC CHEMICALS MANUFACTURING POINT SOURCE CATEGORY Copper Salts Production Subcategory § 415.364 Pretreatment standards for existing sources (PSES). (a) Except as...

40 CFR 415.474 - Pretreatment standards for existing sources (PSES).

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 28 2010-07-01 2010-07-01 true Pretreatment standards for existing... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS INORGANIC CHEMICALS MANUFACTURING POINT SOURCE CATEGORY Nickel Salts Production Subcategory § 415.474 Pretreatment standards for existing sources (PSES). (a) Except as...

40 CFR 415.644 - Pretreatment standards for existing sources (PSES).

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 30 2013-07-01 2012-07-01 true Pretreatment standards for existing... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS INORGANIC CHEMICALS MANUFACTURING POINT SOURCE CATEGORY Cadmium Pigments and Salts Production Subcategory § 415.644 Pretreatment standards for existing sources (PSES). (a...

40 CFR 415.474 - Pretreatment standards for existing sources (PSES).

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 29 2014-07-01 2012-07-01 true Pretreatment standards for existing... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS INORGANIC CHEMICALS MANUFACTURING POINT SOURCE CATEGORY Nickel Salts Production Subcategory § 415.474 Pretreatment standards for existing sources (PSES). (a) Except as...

40 CFR 415.644 - Pretreatment standards for existing sources (PSES).

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 28 2010-07-01 2010-07-01 true Pretreatment standards for existing... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS INORGANIC CHEMICALS MANUFACTURING POINT SOURCE CATEGORY Cadmium Pigments and Salts Production Subcategory § 415.644 Pretreatment standards for existing sources (PSES). (a...

40 CFR 430.46 - Pretreatment standards for existing sources (PSES).

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 30 2014-07-01 2014-07-01 false Pretreatment standards for existing...) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) THE PULP, PAPER, AND PAPERBOARD POINT SOURCE CATEGORY Dissolving Sulfite Subcategory § 430.46 Pretreatment standards for existing sources (PSES). Except as...

40 CFR 415.644 - Pretreatment standards for existing sources (PSES).

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 30 2012-07-01 2012-07-01 false Pretreatment standards for existing... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS INORGANIC CHEMICALS MANUFACTURING POINT SOURCE CATEGORY Cadmium Pigments and Salts Production Subcategory § 415.644 Pretreatment standards for existing sources (PSES). (a...

40 CFR 430.46 - Pretreatment standards for existing sources (PSES).

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 31 2012-07-01 2012-07-01 false Pretreatment standards for existing...) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) THE PULP, PAPER, AND PAPERBOARD POINT SOURCE CATEGORY Dissolving Sulfite Subcategory § 430.46 Pretreatment standards for existing sources (PSES). Except as...

40 CFR 415.644 - Pretreatment standards for existing sources (PSES).

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 29 2014-07-01 2012-07-01 true Pretreatment standards for existing... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS INORGANIC CHEMICALS MANUFACTURING POINT SOURCE CATEGORY Cadmium Pigments and Salts Production Subcategory § 415.644 Pretreatment standards for existing sources (PSES). (a...

40 CFR 429.95 - Pretreatment standards for existing sources (PSES).

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 31 2012-07-01 2012-07-01 false Pretreatment standards for existing...) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) TIMBER PRODUCTS PROCESSING POINT SOURCE CATEGORY Wood Preserving-Boulton Subcategory § 429.95 Pretreatment standards for existing sources (PSES). Except as...

40 CFR 415.654 - Pretreatment standards for existing sources (PSES).

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 30 2013-07-01 2012-07-01 true Pretreatment standards for existing... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS INORGANIC CHEMICALS MANUFACTURING POINT SOURCE CATEGORY Cobalt Salts Production Subcategory § 415.654 Pretreatment standards for existing sources (PSES). Except as...

40 CFR 429.85 - Pretreatment standards for existing sources (PSES).

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 31 2012-07-01 2012-07-01 false Pretreatment standards for existing...) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) TIMBER PRODUCTS PROCESSING POINT SOURCE CATEGORY Wood Preserving Steam Subcategory § 429.85 Pretreatment standards for existing sources (PSES). Except as provided...

40 CFR 415.474 - Pretreatment standards for existing sources (PSES).

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 30 2013-07-01 2012-07-01 true Pretreatment standards for existing... (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS INORGANIC CHEMICALS MANUFACTURING POINT SOURCE CATEGORY Nickel Salts Production Subcategory § 415.474 Pretreatment standards for existing sources (PSES). (a) Except as...

40 CFR 62.2605 - Identification of sources-negative declaration.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Georgia Fluoride Emissions from Existing Primary Aluminum Reduction Plants § 62.2605 Identification of... 19, 1983, certifying that there are no existing primary aluminum reduction plants in the State of... Gases, Organic Compounds and Nitrogen Oxide Emissions From Existing Municipal Waste Combustors With the...

40 CFR 62.2605 - Identification of sources-negative declaration.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Georgia Fluoride Emissions from Existing Primary Aluminum Reduction Plants § 62.2605 Identification of... 19, 1983, certifying that there are no existing primary aluminum reduction plants in the State of... Gases, Organic Compounds and Nitrogen Oxide Emissions From Existing Municipal Waste Combustors With the...

40 CFR 62.2605 - Identification of sources-negative declaration.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Georgia Fluoride Emissions from Existing Primary Aluminum Reduction Plants § 62.2605 Identification of... 19, 1983, certifying that there are no existing primary aluminum reduction plants in the State of... Gases, Organic Compounds and Nitrogen Oxide Emissions From Existing Municipal Waste Combustors With the...

40 CFR 62.2605 - Identification of sources-negative declaration.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Georgia Fluoride Emissions from Existing Primary Aluminum Reduction Plants § 62.2605 Identification of... 19, 1983, certifying that there are no existing primary aluminum reduction plants in the State of... Gases, Organic Compounds and Nitrogen Oxide Emissions From Existing Municipal Waste Combustors With the...

40 CFR 62.2605 - Identification of sources-negative declaration.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Georgia Fluoride Emissions from Existing Primary Aluminum Reduction Plants § 62.2605 Identification of... 19, 1983, certifying that there are no existing primary aluminum reduction plants in the State of... Gases, Organic Compounds and Nitrogen Oxide Emissions From Existing Municipal Waste Combustors With the...

Conditions for the existence of Kelvin-Helmholtz instability in a CME

NASA Astrophysics Data System (ADS)

Jatenco-Pereira, Vera; Páez, Andrés; Falceta-Gonçalves, Diego; Opher, Merav

2015-08-01

The presence of Kelvin-Helmholtz instability (KHI) in the sheaths of the Coronal Mass Ejection (CME) has motivated several analysis and simulations to test their existence. In the present work we assume the existence of the KHI and propose a method to identify the regions where it is possible the development of KHI for a CME propagating in a fast and slow solar wind. We build functions for the velocities, densities and magnetic fields for two different zones of interaction between the solar wind and a CME. Based on the theory of magnetic KHI proposed by Chandrasekhar (1961) and we found conditions for the existence of KHI in the CME sheaths. Using this method it is possible to determine the range of parameters, in particular CME magnetic fields in which the KHI could exist. We conclude that KHI may exist in the two CME flanks and it is perceived that the zone with boundaries with the slow solar wind is more appropriated for the formation of the KHI.

12 CFR 1022.20 - Coverage and definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... contain personal identifiers such as account numbers, names, or addresses. (4) Pre-existing business relationship. (i) In general. The term “pre-existing business relationship” means a relationship between a... by this subpart. (ii) Examples of pre-existing business relationships. (A) If a consumer has a time...

12 CFR 571.20 - Coverage and definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... account numbers, names, or addresses. (4) Pre-existing business relationship. (i) In general. The term “pre-existing business relationship” means a relationship between a person, or a person's licensed...-existing business relationships. (A) If a consumer has a time deposit account, such as a certificate of...

12 CFR 571.20 - Coverage and definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... account numbers, names, or addresses. (4) Pre-existing business relationship. (i) In general. The term “pre-existing business relationship” means a relationship between a person, or a person's licensed...-existing business relationships. (A) If a consumer has a time deposit account, such as a certificate of...

12 CFR 1022.20 - Coverage and definitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... contain personal identifiers such as account numbers, names, or addresses. (4) Pre-existing business relationship—(i) In general. The term “pre-existing business relationship” means a relationship between a... by this subpart. (ii) Examples of pre-existing business relationships. (A) If a consumer has a time...

12 CFR 1022.20 - Coverage and definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... contain personal identifiers such as account numbers, names, or addresses. (4) Pre-existing business relationship. (i) In general. The term “pre-existing business relationship” means a relationship between a... by this subpart. (ii) Examples of pre-existing business relationships. (A) If a consumer has a time...

12 CFR 334.20 - Coverage and definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... account numbers, names, or addresses. (4) Pre-existing business relationship. (i) In general. The term “pre-existing business relationship” means a relationship between a person, or a person's licensed...-existing business relationships. (A) If a consumer has a time deposit account, such as a certificate of...

12 CFR 334.20 - Coverage and definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... account numbers, names, or addresses. (4) Pre-existing business relationship. (i) In general. The term “pre-existing business relationship” means a relationship between a person, or a person's licensed...-existing business relationships. (A) If a consumer has a time deposit account, such as a certificate of...

12 CFR 334.20 - Coverage and definitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... account numbers, names, or addresses. (4) Pre-existing business relationship. (i) In general. The term “pre-existing business relationship” means a relationship between a person, or a person's licensed...-existing business relationships. (A) If a consumer has a time deposit account, such as a certificate of...

12 CFR 571.20 - Coverage and definitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... account numbers, names, or addresses. (4) Pre-existing business relationship. (i) In general. The term “pre-existing business relationship” means a relationship between a person, or a person's licensed...-existing business relationships. (A) If a consumer has a time deposit account, such as a certificate of...

31 CFR 306.127 - Preservation of existing rights.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Preservation of existing rights. 306.127 Section 306.127 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued.... SECURITIES Miscellaneous Provisions § 306.127 Preservation of existing rights. Nothing contained in these...

49 CFR 37.61 - Public transportation programs and activities in existing facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... existing facilities. 37.61 Section 37.61 Transportation Office of the Secretary of Transportation TRANSPORTATION SERVICES FOR INDIVIDUALS WITH DISABILITIES (ADA) Transportation Facilities § 37.61 Public transportation programs and activities in existing facilities. (a) A public entity shall operate a designated...

44 CFR 16.150 - Program accessibility: Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

...: Existing facilities. 16.150 Section 16.150 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT... accessibility: Existing facilities. (a) General. The agency shall operate each program or activity so that the... facilities accessible to and usable by individuals with handicaps; (2) In the case of historic preservation...

40 CFR 62.1350 - Identification of plan.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) APPROVAL AND PROMULGATION OF STATE PLANS FOR DESIGNATED FACILITIES AND POLLUTANTS Colorado Landfill Gas Emissions from Existing Municipal Solid Waste Landfills § 62.1350 Identification of plan. “111(d) Plan for Existing Municipal Solid Waste Landfills Existing in Colorado” and the associated State regulations in Part...

28 CFR 11.3 - Compliance with existing laws.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Compliance with existing laws. 11.3... for Debt Collection § 11.3 Compliance with existing laws. The procurement of the services of private attorneys for debt collection shall be accomplished in accordance with the competitive procurement...

28 CFR 11.3 - Compliance with existing laws.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 28 Judicial Administration 1 2011-07-01 2011-07-01 false Compliance with existing laws. 11.3... for Debt Collection § 11.3 Compliance with existing laws. The procurement of the services of private attorneys for debt collection shall be accomplished in accordance with the competitive procurement...

40 CFR 469.16 - Pretreatment standards for existing sources (PSES).

Code of Federal Regulations, 2011 CFR

2011-07-01

...) EFFLUENT GUIDELINES AND STANDARDS ELECTRICAL AND ELECTRONIC COMPONENTS POINT SOURCE CATEGORY Semiconductor... for existing sources (PSES): (a) Subpart A—Semiconductor PSES Effluent Limitations Pollutant or... liter (mg/l) TTO 1 1.37 (2) 1 Total toxic organics. 2 Not applicable. (b) An existing source submitting...

40 CFR 63.543 - Standards for process sources.

Code of Federal Regulations, 2011 CFR

2011-07-01

... the atmosphere from any existing, new, or reconstructed blast, reverberatory, rotary, or electric... discharge or cause to be discharged into the atmosphere from any existing, new, or reconstructed blast... atmosphere from any existing blast furnace any gases that contain total hydrocarbons in excess of 360 parts...

40 CFR 35.937-11 - Applicability to existing contracts.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Applicability to existing contracts. 35.937-11 Section 35.937-11 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GRANTS AND OTHER... § 35.937-11 Applicability to existing contracts. Some negotiated engineering subagreements already in...

32 CFR 651.46 - Existing EISs.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 4 2010-07-01 2010-07-01 true Existing EISs. 651.46 Section 651.46 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) ENVIRONMENTAL QUALITY ENVIRONMENTAL ANALYSIS OF ARMY ACTIONS (AR 200-2) Environmental Impact Statement § 651.46 Existing EISs. A newly...

47 CFR 17.17 - Existing structures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 1 2010-10-01 2010-10-01 false Existing structures. 17.17 Section 17.17... STRUCTURES Federal Aviation Administration Notification Criteria § 17.17 Existing structures. (a) The requirements found in § 17.23 relating to painting and lighting of antenna structures shall not apply to those...

40 CFR 467.45 - Pretreatment standards for existing sources.

Code of Federal Regulations, 2010 CFR

2010-07-01

... sources. 467.45 Section 467.45 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS ALUMINUM FORMING POINT SOURCE CATEGORY Forging Subcategory § 467.45 Pretreatment standards for existing sources. Except as provided in 40 CFR 403.7 and 403.13, any existing source...

40 CFR 467.35 - Pretreatment standards for existing sources.

Code of Federal Regulations, 2010 CFR

2010-07-01

... sources. 467.35 Section 467.35 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS ALUMINUM FORMING POINT SOURCE CATEGORY Extrusion Subcategory § 467.35 Pretreatment standards for existing sources. (a) Except as provided in 40 CFR 403.7 and 403.13, any existing...

18 CFR 5.6 - Pre-application document.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., flushing flows, reservoir operations, and flood control operations. (v) In the case of an existing licensed...) project facilities and operations, provide information on the existing environment, and existing data or... meeting and site visit required by § 5.8(b)(3)(viii). (2) Project location, facilities, and operations...

78 FR 25264 - Washoe Project-Rate Order No. WAPA-160

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-30

... DEPARTMENT OF ENERGY Western Area Power Administration Washoe Project-Rate Order No. WAPA-160... existing Washoe Project formula rate through September 30, 2017. The existing Non-Firm Power Formula Rate... the existing formula rate for the Washoe Project, Stampede Division (Project), Non-Firm Power [[Page...

39 CFR 3005.14 - Service of subpoenas.

Code of Federal Regulations, 2010 CFR

2010-07-01

... BY THE POSTAL SERVICE Subpoenas § 3005.14 Service of subpoenas. (a) Manner of service. (1) Existing... this chapter, subpoenas directed to existing Postal Service officers and employees must be served by... delivered by the Postal Service to the existing officers and employees responsible for providing the...

48 CFR 227.7105 - Contracts for the acquisition of existing works.

Code of Federal Regulations, 2010 CFR

2010-10-01

... COPYRIGHTS Rights in Technical Data 227.7105 Contracts for the acquisition of existing works. ... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Contracts for the acquisition of existing works. 227.7105 Section 227.7105 Federal Acquisition Regulations System DEFENSE...

40 CFR 430.96 - Pretreatment standards for existing sources (PSES).

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 31 2012-07-01 2012-07-01 false Pretreatment standards for existing...) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) THE PULP, PAPER, AND PAPERBOARD POINT SOURCE CATEGORY Secondary Fiber Deink Subcategory § 430.96 Pretreatment standards for existing sources (PSES). (a) Except as...

40 CFR 455.26 - Pretreatment standards for existing sources (PSES).

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 30 2011-07-01 2011-07-01 false Pretreatment standards for existing...) EFFLUENT GUIDELINES AND STANDARDS PESTICIDE CHEMICALS Organic Pesticide Chemicals Manufacturing Subcategory § 455.26 Pretreatment standards for existing sources (PSES). Except as provided in 40 CFR 403.7, any...

40 CFR 430.36 - Pretreatment standards for existing sources (PSES).

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 31 2012-07-01 2012-07-01 false Pretreatment standards for existing...) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) THE PULP, PAPER, AND PAPERBOARD POINT SOURCE CATEGORY Unbleached Kraft Subcategory § 430.36 Pretreatment standards for existing sources (PSES). Except as provided...

40 CFR 430.36 - Pretreatment standards for existing sources (PSES).

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 30 2014-07-01 2014-07-01 false Pretreatment standards for existing...) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) THE PULP, PAPER, AND PAPERBOARD POINT SOURCE CATEGORY Unbleached Kraft Subcategory § 430.36 Pretreatment standards for existing sources (PSES). Except as provided...

40 CFR 430.76 - Pretreatment standards for existing sources (PSES).

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 31 2012-07-01 2012-07-01 false Pretreatment standards for existing...) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) THE PULP, PAPER, AND PAPERBOARD POINT SOURCE CATEGORY Mechanical Pulp Subcategory § 430.76 Pretreatment standards for existing sources (PSES). (a) The following...

40 CFR 455.26 - Pretreatment standards for existing sources (PSES).

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 31 2012-07-01 2012-07-01 false Pretreatment standards for existing...) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) PESTICIDE CHEMICALS Organic Pesticide Chemicals Manufacturing Subcategory § 455.26 Pretreatment standards for existing sources (PSES). Except as provided in 40 CFR 403.7...

40 CFR 430.16 - Pretreatment standards for existing sources (PSES).

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 31 2012-07-01 2012-07-01 false Pretreatment standards for existing...) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) THE PULP, PAPER, AND PAPERBOARD POINT SOURCE CATEGORY Dissolving Kraft Subcategory § 430.16 Pretreatment standards for existing sources (PSES). Except as provided...

40 CFR 455.26 - Pretreatment standards for existing sources (PSES).

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 29 2010-07-01 2010-07-01 false Pretreatment standards for existing...) EFFLUENT GUIDELINES AND STANDARDS PESTICIDE CHEMICALS Organic Pesticide Chemicals Manufacturing Subcategory § 455.26 Pretreatment standards for existing sources (PSES). Except as provided in 40 CFR 403.7, any...

40 CFR 430.96 - Pretreatment standards for existing sources (PSES).

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 30 2014-07-01 2014-07-01 false Pretreatment standards for existing...) EFFLUENT GUIDELINES AND STANDARDS (CONTINUED) THE PULP, PAPER, AND PAPERBOARD POINT SOURCE CATEGORY Secondary Fiber Deink Subcategory § 430.96 Pretreatment standards for existing sources (PSES). (a) Except as...

40 CFR 62.10140 - Identification of plan-negative declaration.

Code of Federal Regulations, 2013 CFR

2013-07-01

... POLLUTANTS South Carolina Fluoride Emissions from Existing Primary Aluminum Reduction Plants § 62.10140... submitted on May 3, 1983, a letter certifying that there are no existing primary aluminum plants in the... gases, Organic Compounds And Nitrogen Oxide Emissions From Existing Municipal Waste Combustors With The...

40 CFR 62.10140 - Identification of plan-negative declaration.

Code of Federal Regulations, 2014 CFR

2014-07-01

... POLLUTANTS South Carolina Fluoride Emissions from Existing Primary Aluminum Reduction Plants § 62.10140... submitted on May 3, 1983, a letter certifying that there are no existing primary aluminum plants in the... gases, Organic Compounds And Nitrogen Oxide Emissions From Existing Municipal Waste Combustors With The...

40 CFR 62.10140 - Identification of plan-negative declaration.

Code of Federal Regulations, 2010 CFR

2010-07-01

... POLLUTANTS South Carolina Fluoride Emissions from Existing Primary Aluminum Reduction Plants § 62.10140... submitted on May 3, 1983, a letter certifying that there are no existing primary aluminum plants in the... gases, Organic Compounds And Nitrogen Oxide Emissions From Existing Municipal Waste Combustors With The...

40 CFR 62.10140 - Identification of plan-negative declaration.

Code of Federal Regulations, 2011 CFR

2011-07-01

... POLLUTANTS South Carolina Fluoride Emissions from Existing Primary Aluminum Reduction Plants § 62.10140... submitted on May 3, 1983, a letter certifying that there are no existing primary aluminum plants in the... gases, Organic Compounds And Nitrogen Oxide Emissions From Existing Municipal Waste Combustors With The...

40 CFR 62.10140 - Identification of plan-negative declaration.

Code of Federal Regulations, 2012 CFR

2012-07-01

... POLLUTANTS South Carolina Fluoride Emissions from Existing Primary Aluminum Reduction Plants § 62.10140... submitted on May 3, 1983, a letter certifying that there are no existing primary aluminum plants in the... gases, Organic Compounds And Nitrogen Oxide Emissions From Existing Municipal Waste Combustors With The...

Nurses' knowledge to identify early acute kidney injury.

PubMed

Nascimento, Roseli Aparecida Matheus do; Assunção, Murillo Santucci Cesar; Silva, João Manoel; Amendola, Cristina Prata; Carvalho, Taysa Martindo de; Lima, Emerson Quintino; Lobo, Suzana Margareth Ajeje

2016-01-01

To evaluate the knowledgeof nurses on early identification of acute kidney injury (AKI) in intensive care, emergency and hospitalization units. A prospective multi-center study was conducted with 216 nurses, using a questionnaire with 10 questions related to AKI prevention, diagnosis, and treatment. 57.2% of nurses were unable to identify AKI clinical manifestations, 54.6% did not have knowledge of AKI incidence in patients admitted to the ICU, 87.0% of the nurses did not know how to answer as regards the AKI mortality rate in patients admitted to the ICU, 67.1% answered incorrectly that slight increases in serum creatinine do not have an impact on mortality, 66.8% answered incorrectly to the question on AKI prevention measures, 60.4% answered correctly that loop diuretics for preventing AKI is not recommended, 77.6% answered correctly that AKI does not characterize the need for hemodialysis, and 92.5% said they had no knowledge of the Acute Kidney Injury Networkclassification. Nurses do not have enough knowledge to identify early AKI, demonstrating the importance of qualification programs in this field of knowledge. Avaliar o conhecimento do enfermeiro na identificação precoce da Injúria Renal Aguda (IRA) em Unidade de Terapia Intensiva, Unidade de Internação e Emergência. Estudo multicêntrico, prospectivo.Participaram do estudo 216 enfermeiros,por meio de questionário com 10 questões relacionadas à prevenção, ao diagnóstico e ao tratamento da IRA. 57,2% não souberam identificar as manifestações clínicas da IRA, 54,6% não têm conhecimento da incidência de IRA em pacientes internados na UTI, 87,0% dos enfermeiros não souberam responder ao índice de mortalidade de IRA em pacientes internados na UTI, 67,1% responderam incorretamente que aumentos discretos da creatinina sérica não têm impacto na mortalidade, 66,8% responderam incorretamente à questão sobre as medidas de prevenção da IRA, 60,4% acertaram quando responderam que não é recomendada a utilização de diuréticos de alça na prevenção da IRA, 77,6% acertaram ao responder que IRA não caracteriza necessidade de hemodiálise e 92,5% disseram não conhecer a classificação AKIN. Enfermeiros não têm conhecimento suficiente para a identificação precoce da IRA, mostrando a importância de programas de capacitação nesta área do conhecimento.

Chinese phytotherapy to reduce stress, anxiety and improve quality of life: randomized controlled trial.

PubMed

Kurebayashi, Leonice Fumiko Sato; Turrini, Ruth Natalia Teresa; Kuba, Gisele; Shimizu, Miki Hoshi Minamizawa; Takiguch, Raymond Sehiji

2016-01-01

To evaluate the effect of Chinese phytotherapyto reduce stress levels, anxiety and improve quality of life. double-blind randomized controlled trial with 89 volunteers divided into three groups: control (no intervention), Placebo and Phytotherapy. The study was conducted in 2015 with healthy adults treated at the Integrated and Eastern Therapy Institute,in Sao Paulo, Brazil. Participants were evaluated at baseline and after three weeks with the Stress Symptoms List (SSL), Anxiety Inventory-Trait and State and SF12v2 for quality of life. Intervention groups received a placebo or Gan May Zao formula (GMDZ)flaskwith 50 ml. According to ANOVA, there were significant differences (p = 0.025) after treatment of stress (SSL2). And the difference was between control and Phytotherapy groups, according to the Tukey post hoc (p = 0.022). There were no differences in the levels of state-anxiety and physical and mental domains in the SF12v2. The GMDZ formula reduced stress levels, but more studies are needed with greater sample, with reassessment of dosage and a longer period of treatment to confirm and extend the results. Brazilian Registry of Clinical Trials: RBR-28s4hz. Avaliar o efeito da fitoterapia chinesa na redução de níveis de estresse, ansiedade e melhoria de qualidade de vida. Ensaio clínico randomizado duplo-cego, com 89 voluntários divididos em três grupos: Controle (sem intervenção), Placebo e Fitoterapia. Foi realizado em 2015, com adultos saudáveis atendidos no Instituto de Terapia Integrada e Oriental, São Paulo. Foram avaliados no baseline e, após 3 semanas,pela Lista de Sintomas de Stress (LSS), Inventário de Ansiedade-Traço e Estado e o SF12v2 de qualidade de vida. Os grupos de intervenção receberam um frasco de 50 ml de placebo ou da fórmula Gan Mai Da Zao (GMDZ). Segundo ANOVA, houve diferença (p=0,025) no pós-tratamento de estresse (LSS2). E a diferença foi entre os grupos Controle e Fitoterapia, de acordo com o post hocde Tukey (p=0,022). Não houve diferenças nos níveis de ansiedade-estado e domínio físico e mental do SF12v2. A fórmula GMDZ reduziu os níveis de estresse, mas são necessários mais estudos com amostra significativa, com reavaliação da posologia e um período maior de tratamento para confirmar e ampliar os resultados. Registro Brasileiro de Ensaios Clínicos: RBR-28s4hz.

Sleep, quality of life and mood of nursing professionals of pediatric intensive care units.

PubMed

Guerra, Priscilla Caetano; Oliveira, Nilton Ferraro; Terreri, Maria Teresa de Sande E Lemos Ramos Ascensão; Len, Claudio Arnaldo

2016-04-01

To assess sleep, quality of life and mood of nursing professionals of pediatric intensive care units. Quantitative, cross-sectional and descriptive study. Professionals grouped by morning, afternoon and evening shifts were assessed by means of the instruments: Morningness-Eveningness Questionnaire; Pittsburgh Sleep Quality Index; Epworth Sleepiness Scale; Generic questionnaire for the assessment of quality of life (SF-36); Beck Depression Inventory; Beck Anxiety Inventory; State-Trait Anxiety Inventory. Sample consisted of 168 professionals, with prevalence of neutral typology (57.49%). There was no statistical significance regarding sleep, despite scores showing a poor quality of sleep and excessive daytime sleepiness for the three shifts. Quality of life did not reveal any statistical significance, but in the field "social role functioning" of the evening shift, a lower score was observed (p<0.007). There was no statistical significance regarding levels of anxiety and depression. The results suggest that these professionals may present sleeping problems, but they do not have lower scores of quality of life or mood disorders. Likely explanations for these findings may include an adaptation to their work type over time and the fact that working with children is rewarding. Avaliar sono, qualidade de vida e humor em profissionais de enfermagem em Unidades de Terapia Intensiva Infantil. Estudo quantitativo, transversal e descritivo. Profissionais agrupados por turnos matutino, vespertino e noturno foram avaliados pelos instrumentos: Questionário de identificação Matutinidade-Vespertinidade; Índice de qualidade do sono de Pittsburgh; Escala de sonolência Epworth; Questionário genérico de avaliação de qualidade de vida - SF-36; Inventário de depressão de Beck; Inventário de ansiedade de Beck; Inventário de ansiedade Traço-Estado. Amostra composta por 168 profissionais, predominando tipologia neutra, 57,49%. Não houve significância estatística quanto ao sono, apesar dos escores mostrarem qualidade ruim e sonolência diurna excessiva para os três turnos. A qualidade de vida não denotou diferença estatística, mas no domínio "aspecto social" do turno noturno, observou-se escore pior (p<0,007). Não houve significância estatística nos níveis de ansiedade e depressão. Os resultados sugerem que estes profissionais podem apresentar problemas no sono, entretanto não apresentam escores mais baixos de qualidade de vida ou transtornos do humor. Possíveis explicações para estes achados são que haja uma adaptação ao regime de trabalho ao longo do tempo e que trabalhar com crianças seja recompensador.

Reported Church Attendance at the Time of Entry into HIV Care is Associated with Viral Load Suppression at 12 Months.

PubMed

Van Wagoner, Nicholas; Elopre, Latesha; Westfall, Andrew O; Mugavero, Michael J; Turan, Janet; Hook, Edward W

2016-08-01

The Southeast has high rates of church attendance and HIV infection rates. We evaluated the relationship between church attendance and HIV viremia in a Southeastern US, HIV-infected cohort. Viremia (viral load ≥200 copies/ml) was analyzed 12 months after initiation of care. Univariate and multivariable logistic regression models were fit for variables potentially related to viremia. Of 382 patients, 74 % were virally suppressed at 12 months. Protective variables included church attendance (AOR 0.5; 95 % CI 0.2, 0.9), being on antiretroviral therapy (AOR 0.01; 95 % CI 0.004, 0.04), CD4(+) T lymphocyte count 200-350 cells/mm(3) at care entry (AOR 0.3; 95 % 0.1, 0.9), and education (AOR 0.5; 95 % CI 0.2, 0.9). Variables predicting viremia included black race (AOR 3.2; 95 % CI 1.4, 7.4) and selective disclosure of HIV status (AOR 2.7; 95 % CI 1.2, 5.6). Church attendance may provide needed support for patients entering HIV care for the first time. El Sur Este de los Estados Unidos tiene tasas altas de visitas a iglesias y de infección por VIH. Evaluamos la relación entre visitas a iglesias y viremia por VIH en una cohorte de pacientes infectados con VIH en el Sur Este de los EEUU. La viremia (carga viral ≥ 200 copias/ml) fue analizada a los 12 meses de iniciar el cuidado médico. Los modelos de regresión logística univariado y multivariado fueron ajustados para variables potencialmente relacionadas a viremia. De 382 pacientes, 75 % tuvieron supresión virológica a los 12 meses. Variables que ofrecieron protección fueron visitas a iglesias (AOR 0.5; IC95 % 0.2-0.9), recibir terapia antiretroviral (AOR 0.01; IC95 % 0.004,0.04), recuento de linfocitos T CD4 + 200-350 al iniciar cuidado médico (AOR 0.3; IC95 % 0.1,09), y educación (AOR 0.5; IC95 % 0.2,0.9). Las variables que predijeron viremia incluyeron raza negra (AOR 3.2; IC95 % 1.4,7.4) y la comunicación selectiva del diagnóstico de VIH a otras personas (AOR 2.7; 95 % IC 1.2, 5.6). El asistir a iglesias puede proveer un suporte a los pacientes que inician cuidado médico por infección por VIH.

PATHOPHYSIOLOGY, DIAGNOSIS AND TREATMENTOF DUMPING SYNDROME AND ITS RELATION TO BARIATRIC SURGERY.

PubMed

Chaves, Yasmin da Silva; Destefani, Afrânio Côgo

The dumping syndrome is frequent in bariatric surgery. It is probably the most common syndrome following partial or complete gastrectomy. Its prevalence in partial gastrectomy can reach up to 50%, thus it can be a significant complication arising from some types of bariatric surgeries. Critical analysis on dumping syndrome, its pathophysiology, diagnosis and treatment. A literature review was performed using the key words: 'dumping syndrome', 'bariatric surgery' and 'rapid dumping syndrome'. Inclusion criteria were: books, original works, case reports and meta-analyzes, and the exclusion criterion was literature review. Concerning the publication time, articles were screened between 1960 and May 2015. The dumping syndrome is complication arising from obesity surgeries, but also can be a result of vagus nerve damage. Diagnosis is done primarily through the use of questionnaires based on scores. The Sigstad score and Arts survey are valid means for assessing the dumping syndrome. Initial therapy consists in the adoption of dietary measures, short acting drugs administration. A síndrome de dumping é frequente após operações bariátricas. É, provavelmente, a mais comum das síndromes que sucedem gastrectomias parciais ou completas. Sua prevalência, em gastrectomias parciais pode chegar a até 50%, tornando-se assim complicação significante em alguns tipos de operações bariátricas. Realizar análise crítica sobre a síndrome de dumping em sua fisiopatologia, diagnóstico e tratamento. Foi realizada revisão bibliográfica utilizando os descritores: 'síndrome de dumping', 'cirurgia bariátrica' e 'síndrome do esvaziamento rápido'. Os critérios de inclusão foram: livros, trabalhos originais, relatos de caso e metanálises; excluíram-se as revisões bibliográficas. Quanto ao tempo de publicação, foram selecionados artigos entre 1960 e maio de 2015. A síndrome de dumping é complicação gastrointestinal oriunda de operações para obesidade, mas também pode ocasionar-se como consequência de danos no nervo vago. Seu diagnóstico é realizado primordialmente através da aplicação de questionários baseados em pontuações. O escore de Sigstad e questionário de Arts são meios válidos para avaliação da síndrome de dumping. A terapia inicial consiste na adoção de medidas dietéticas, ou fármacos administráveis de ação curta.

75 FR 25195 - Kake to Petersburg Transmission Line Intertie Project

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-07

... existing roads for construction and long-term maintenance access where possible. New road segments would be.... Both routes would use existing roads for construction and long-term maintenance access where possible...). Both alternative routes follow existing logging roads for the majority of their lengths. In addition...

A structural classification for inland northwest forest vegetation.

Treesearch

Kevin L. O' Hara; Penelope A. Latham; Paul Hessburg; Bradley G. Smith

1996-01-01

Existing approaches to vegetation classification range from those bassed on potential vegetation to others based on existing vegetation composition, or existing structural or physiognomic characteristics. Examples of these classifications are numerous, and in some cases, date back hundreds of years (Mueller-Dumbois and Ellenberg 1974). Small-scale or stand level...

76 FR 47068 - Approval and Promulgation of Air Quality Implementation Plans; Delaware; Section 110(a)(2...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-04

... concerns involving provisions in existing SIPs and with EPA's statements in other proposals that it would...) Existing provisions related to excess emissions during periods of start-up, shutdown, or malfunction (SSM... (ii) existing provisions related to ``director's variance'' or ``director's discretion'' that purport...

75 FR 36756 - Self-Regulatory Organizations; Financial Industry Regulatory Authority, Inc.; Notice of Filing of...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-28

... existing paragraph (b)(4) of the Rule, entitled ``Numerical Guidelines Applicable to Volatile Market Opens... existing paragraph (b)(2), which provides flexibility to FINRA to use different Numerical Guidelines or... of paragraph (b)(4) (``Numerical Guidelines Applicable to Volatile Market Opens'') of the existing...

48 CFR 27.405-2 - Existing works.

Code of Federal Regulations, 2014 CFR

2014-10-01

... REQUIREMENTS PATENTS, DATA, AND COPYRIGHTS Rights in Data and Copyrights 27.405-2 Existing works. The clause at 52.227-18, Rights in Data—Existing Works, is for use in contracts exclusively for the acquisition.... Examples of these limitations are means of exhibition or transmission, time, type of audience, and...

Proposed Unit Level Ozone Season NOx Allowance Allocations to Existing Units in Six States: Supplemental Proposed Rule TSD

EPA Pesticide Factsheets

This Technical Support Document (TSD) presents the proposed unit-level allocations based on the existing-unit portion of each state’s ozone season NOx emission budget to covered existing units in Iowa, Kansas, Michigan, Missouri, Oklahoma, and Wisconsin.

Existence of the Stark-Wannier quantum resonances

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sacchetti, Andrea, E-mail: andrea.sacchetti@unimore.it

2014-12-15

In this paper, we prove the existence of the Stark-Wannier quantum resonances for one-dimensional Schrödinger operators with smooth periodic potential and small external homogeneous electric field. Such a result extends the existence result previously obtained in the case of periodic potentials with a finite number of open gaps.

Global existence of the three-dimensional viscous quantum magnetohydrodynamic model

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yang, Jianwei, E-mail: yangjianwei@ncwu.edu.cn; Ju, Qiangchang, E-mail: qiangchang-ju@yahoo.com

2014-08-15

The global-in-time existence of weak solutions to the viscous quantum Magnetohydrodynamic equations in a three-dimensional torus with large data is proved. The global existence of weak solutions to the viscous quantum Magnetohydrodynamic equations is shown by using the Faedo-Galerkin method and weak compactness techniques.

Experimental Treatment for Duchenne Muscular Dystrophy Gets Boost from Existing Medication

MedlinePlus

... Boost from Existing Medication Spotlight on Research Experimental Treatment for Duchenne Muscular Dystrophy Gets Boost from Existing Medication By Colleen Labbe, M.S. | March 1, 2013 A mouse hanging on a wire during a test of muscle strength. Mice with a mutant dystrophin gene, which ...

48 CFR 27.405-4 - Other existing data.

Code of Federal Regulations, 2010 CFR

2010-10-01

... is required to be included in contracts substantially for on-line data base services in the same form... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Other existing data. 27... CONTRACTING REQUIREMENTS PATENTS, DATA, AND COPYRIGHTS Rights in Data and Copyrights 27.405-4 Other existing...

48 CFR 27.405-4 - Other existing data.

Code of Federal Regulations, 2014 CFR

2014-10-01

... is required to be included in contracts substantially for on-line data base services in the same form... 48 Federal Acquisition Regulations System 1 2014-10-01 2014-10-01 false Other existing data. 27... CONTRACTING REQUIREMENTS PATENTS, DATA, AND COPYRIGHTS Rights in Data and Copyrights 27.405-4 Other existing...

48 CFR 27.405-4 - Other existing data.

Code of Federal Regulations, 2011 CFR

2011-10-01

... is required to be included in contracts substantially for on-line data base services in the same form... 48 Federal Acquisition Regulations System 1 2011-10-01 2011-10-01 false Other existing data. 27... CONTRACTING REQUIREMENTS PATENTS, DATA, AND COPYRIGHTS Rights in Data and Copyrights 27.405-4 Other existing...

48 CFR 27.405-4 - Other existing data.

Code of Federal Regulations, 2012 CFR

2012-10-01

... is required to be included in contracts substantially for on-line data base services in the same form... 48 Federal Acquisition Regulations System 1 2012-10-01 2012-10-01 false Other existing data. 27... CONTRACTING REQUIREMENTS PATENTS, DATA, AND COPYRIGHTS Rights in Data and Copyrights 27.405-4 Other existing...

48 CFR 27.405-4 - Other existing data.

Code of Federal Regulations, 2013 CFR

2013-10-01

... is required to be included in contracts substantially for on-line data base services in the same form... 48 Federal Acquisition Regulations System 1 2013-10-01 2013-10-01 false Other existing data. 27... CONTRACTING REQUIREMENTS PATENTS, DATA, AND COPYRIGHTS Rights in Data and Copyrights 27.405-4 Other existing...

77 FR 24505 - Hazard Mitigation Assistance for Wind Retrofit Projects for Existing Residential Buildings

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-24

...] Hazard Mitigation Assistance for Wind Retrofit Projects for Existing Residential Buildings AGENCY... for Wind Retrofit Projects for Existing Residential Buildings. DATES: Comments must be received by... property from hazards and their effects. One such activity is the implementation of wind retrofit projects...

40 CFR 435.46 - Pretreatment standards of performance for existing sources (PSES).

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 31 2013-07-01 2013-07-01 false Pretreatment standards of performance for existing sources (PSES). 435.46 Section 435.46 Protection of Environment ENVIRONMENTAL PROTECTION... CATEGORY Coastal Subcategory § 435.46 Pretreatment standards of performance for existing sources (PSES...

40 CFR 435.46 - Pretreatment standards of performance for existing sources (PSES).

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 31 2012-07-01 2012-07-01 false Pretreatment standards of performance for existing sources (PSES). 435.46 Section 435.46 Protection of Environment ENVIRONMENTAL PROTECTION... CATEGORY Coastal Subcategory § 435.46 Pretreatment standards of performance for existing sources (PSES...

40 CFR 435.46 - Pretreatment standards of performance for existing sources (PSES).

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 30 2014-07-01 2014-07-01 false Pretreatment standards of performance for existing sources (PSES). 435.46 Section 435.46 Protection of Environment ENVIRONMENTAL PROTECTION... CATEGORY Coastal Subcategory § 435.46 Pretreatment standards of performance for existing sources (PSES...

77 FR 28391 - Announcement of Requirements and Registration for “Ocular Imaging Challenge”

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-14

..., color, zoom, pan) Integrate with existing EHRs (e.g. ``single sign-on'') Where applicable, leverage and... existing office hardware platforms, and to integrate with existing EHR systems (e.g. ``single sign-on... on the acquisition devices in proprietary databases and file formats, and therefore have limited...

75 FR 17938 - Privacy Act of 1974; Deletion of an Existing System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-08

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Privacy Act of 1974; Deletion of an Existing System of Records AGENCY: Department of Health and Human Services (HHS), Health Resources and Services Administration (HRSA). ACTION: Notice to delete an existing system...

75 FR 17937 - Privacy Act of 1974; Deletion of an Existing System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-08

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Privacy Act of 1974; Deletion of an Existing System of Records AGENCY: Department of Health and Human Services (HHS), Health Resources and Services Administration (HRSA). ACTION: Notice to delete an existing HRSA...

28 CFR 11.3 - Compliance with existing laws.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 1 2013-07-01 2013-07-01 false Compliance with existing laws. 11.3... for Debt Collection § 11.3 Compliance with existing laws. The procurement of the services of private... procedures mandated by Federal law, and set forth in the Federal Property and Administrative Services Act of...

30 CFR 780.12 - Operation plan: Existing structures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... each existing structure proposed to be used in connection with or to facilitate the surface coal mining... which describe its current condition; (3) Approximate dates on which construction of the existing... proposed to be modified or reconstructed for use in connection with or to facilitate the surface coal...

30 CFR 784.12 - Operation plan: Existing structures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... each existing structure proposed to be used in connection with or to facilitate the surface coal mining... which describe its current condition; (3) Approximate dates on which construction of the existing... proposed to be modified or reconstructed for use in connection with or to facilitate the surface coal...

14 CFR 216.6 - Existing unauthorized operations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... PROCEEDINGS) ECONOMIC REGULATIONS COMMINGLING OF BLIND SECTOR TRAFFIC BY FOREIGN AIR CARRIERS § 216.6 Existing... existing blind sector operations which have been regularly performed by such carrier commencing on a date prior to August 9, 1967, such carrier may continue to engage in such blind sector operations until final...

41 CFR 60-1.45 - Existing contracts and subcontracts.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 1 2010-07-01 2010-07-01 true Existing contracts and subcontracts. 60-1.45 Section 60-1.45 Public Contracts and Property Management Other Provisions Relating to... OF LABOR 1-OBLIGATIONS OF CONTRACTORS AND SUBCONTRACTORS Ancillary Matters § 60-1.45 Existing...

41 CFR 60-1.45 - Existing contracts and subcontracts.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 41 Public Contracts and Property Management 1 2011-07-01 2009-07-01 true Existing contracts and subcontracts. 60-1.45 Section 60-1.45 Public Contracts and Property Management Other Provisions Relating to... OF LABOR 1-OBLIGATIONS OF CONTRACTORS AND SUBCONTRACTORS Ancillary Matters § 60-1.45 Existing...

40 CFR 421.95 - Pretreatment standards for existing sources.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Plants Subcategory § 421.95 Pretreatment standards for existing sources. Except as provided in 40 CFR 403... standards for existing sources. The mass of wastewater pollutants in metallurgical acid plant blowdown introduced into a POTW shall not exceed the following values: Subpart I—Metallurgical Acid Plant—PSES...

40 CFR 421.95 - Pretreatment standards for existing sources.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Plants Subcategory § 421.95 Pretreatment standards for existing sources. Except as provided in 40 CFR 403... standards for existing sources. The mass of wastewater pollutants in metallurgical acid plant blowdown introduced into a POTW shall not exceed the following values: Subpart I—Metallurgical Acid Plant—PSES...

18 CFR 4.50 - Applicability.

Code of Federal Regulations, 2014 CFR

2014-04-01

... PROJECT COSTS Application for License for Major Project-Existing Dam § 4.50 Applicability. (a... to any application for either an initial license or new license for a major project—existing dam that... apply to any major project—existing dam (see § 4.40) that is proposed to entail or include: (i) Any...

18 CFR 4.50 - Applicability.

Code of Federal Regulations, 2013 CFR

2013-04-01

... PROJECT COSTS Application for License for Major Project-Existing Dam § 4.50 Applicability. (a... to any application for either an initial license or new license for a major project—existing dam that... apply to any major project—existing dam (see § 4.40) that is proposed to entail or include: (i) Any...

18 CFR 4.50 - Applicability.

Code of Federal Regulations, 2012 CFR

2012-04-01

... PROJECT COSTS Application for License for Major Project-Existing Dam § 4.50 Applicability. (a... to any application for either an initial license or new license for a major project—existing dam that... apply to any major project—existing dam (see § 4.40) that is proposed to entail or include: (i) Any...

75 FR 5604 - Privacy Act of 1974; Deletion of an Existing System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-03

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Privacy Act of 1974; Deletion of an Existing System of Records AGENCY: Department of Health and Human Services... deleting an existing system of records titled the ``Disability Claims in the Health Professions Student...

18 CFR 4.50 - Applicability.

Code of Federal Regulations, 2011 CFR

2011-04-01

... PROJECT COSTS Application for License for Major Project-Existing Dam § 4.50 Applicability. (a... to any application for either an initial license or new license for a major project—existing dam that... apply to any major project—existing dam (see § 4.40) that is proposed to entail or include: (i) Any...

18 CFR 4.50 - Applicability.

Code of Federal Regulations, 2010 CFR

2010-04-01

... PROJECT COSTS Application for License for Major Project-Existing Dam § 4.50 Applicability. (a... to any application for either an initial license or new license for a major project—existing dam that... apply to any major project—existing dam (see § 4.40) that is proposed to entail or include: (i) Any...

49 CFR 214.513 - Retrofitting of existing on-track roadway maintenance machines; general.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Retrofitting of existing on-track roadway maintenance machines; general. 214.513 Section 214.513 Transportation Other Regulations Relating to... SAFETY On-Track Roadway Maintenance Machines and Hi-Rail Vehicles § 214.513 Retrofitting of existing on...

40 CFR 401.12 - Law authorizing establishment of effluent limitations guidelines for existing sources, standards...

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 29 2011-07-01 2009-07-01 true Law authorizing establishment of effluent limitations guidelines for existing sources, standards of performance for new sources and pretreatment standards of new and existing sources. 401.12 Section 401.12 Protection of Environment...

10 CFR 1040.72 - Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Existing facilities. 1040.72 Section 1040.72 Energy... § 1040.72 Existing facilities. (a) Accessibility. A recipient shall operate any program or activity to... facilities or every part of a facility accessible to and useable by handicapped persons. (b) Methods. A...

76 FR 43230 - National Pollutant Discharge Elimination System-Cooling Water Intake Structures at Existing...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-20

... Facilities and Phase I Facilities AGENCY: Environmental Protection Agency (EPA). ACTION: Proposed rule...) of the Clean Water Act for all existing power generating facilities and existing manufacturing and industrial facilities. EPA requested that public comments on the proposal be submitted on or before July 19...